ISSN: 1859 - 2872
Klebsiella pneumoniae Invasive Liver Abscess Syndrome (KILAS) with purulent meningitis and endophthalmitis: case report and literature review
Main Article Content
Keywords
Klebsiella pneumoniae, sepsis, liver abscess, endophthalmitis, meningitis, Klebsiella pneumoniae Invasive Liver Abscess Syndrome (KILAS).
Abstract
Klebsiella pneumoniae Invasive Liver Abscess Syndrome (KILAS) was defined as K. pneumoniae liver abscess with extrahepatic complications. The endophthalmitis or meningitis is among the most common metastatic infections in KILAS, however, patients with both of them have been scarce. Herein, we report an 86-year-old woman admitted to the 108 Military Central Hospital for her primary liver abscess and purulent meningitis caused by K. pneumoniae. The appropriate parenteral antibiotics with the optimal dose for treatment of meningitis were properly administrated, followed by percutaneous drainage of liver abscess; her infection gradually declined, nevertheless was then suddenly worsened along with newly diagnosed endophthalmitis in her left eye. The intravitreal antibiotic was immediately performed which may finally result in her infection eradication. We report a typical case of and literature reviews about KILAS with purulent meningitis and endophthalmitis.
Article Details
References
1. Siu LK, Yeh KM, Lin JC, Fung CP, Chang FY (2012) Klebsiella pneumoniae liver abscess: a new invasive syndrome. Lancet Infect Dis 12(11): 881-887.
2. Li F, Zheng W, Yu J et al (2022) Klebsiella pneumoniae liver abscess with purulent meningitis and endogenous endophthalmitis: A case report. Front Surg 9(1): 894929.
3. Liu JA-O, Dai M, Sun Q et al (2022) A typical multisite invasive infection caused by hvKP: A case report and literature review. Medicine (Baltimore) 101(52): 32592.
4. Saccente M (1999) Klebsiella pneumoniae Liver Abscess, Endophthalmitis, and Meningitis in a Man with Newly Recognized Diabetes Mellitus. Clin Infect Dis 29(6):1570-1571.
5. Nguyễn Thị Huyền Trang, Trần Thị Ánh Tuyết, Nguyễn Anh Tuấn và cộng sự (2024) Đặc điểm lâm sàng, cận lâm sàng ở bệnh nhân áp xe gan điều trị tại Bệnh viện Trung ương Quân đội 108. Tạp chí Y dược lâm sàng 108 19(1), tr. 40-47.
6. Pham Van Chung, Nguyen Thi Hiep, Hoang Dinh Nhu et al (2022) Clinical features, laboratory characteristics and treatment outcomes of liver abscess at the Institute of Clinical Infectious Diseases - 108 Military Central Hospital. Journal of 108 - Clinical Medicine and Phamarcy 17(52-8): 7.
7. Yu WL, Ko WC, Cheng KC, Lee HC, Ke DS, Lee CC, Fung CP, Chuang YC (2006) Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan. Clin Infect Dis 42(10): 1351-1358.
8. Fang CT, Lai SY, Yi WC, Hsueh PR, Liu KL, Chang SC (2007) Klebsiella pneumoniae genotype K1: An emerging pathogen that causes septic ocular or central nervous system complications from pyogenic liver abscess. Clin Infect Dis 45(3): 284-293.
9. Cong Long Nguyen, Truong Khanh Vu, Van Son Tran, et al (2022) Management of 96 Patients with Pyogenic Liver Abscess Admitted to a Single Hospital in Hanoi City, Vietnam, 2015-2020: Etiology, Drug Resistance, Complications, and the Outcomes. Biomed J Sci & Tech Res 42(4): 33922-33927.
10. Huynh Thanh Long, Khiem NM (2023) Clinical and laboratory characteristics of liver abscess patients at Nguyen Tri Phuong hospital. Vietnam Medical Journal 2(1): 130-138.
11. Nguyen L, Pham T, Luu D et al (2023) A retrospective study of endogenous endophthalmitis-related pyogenic liver abscess: An increasing complication in North Vietnam. SAGE Open Med 18(11): 1-5.
12. Lee SS, Chen YS, Tsai HC, Wann SR, Lin HH, Huang CK, Liu YC (2008) Predictors of septic metastatic infection and mortality among patients with Klebsiella pneumoniae liver abscess. Clin Infect Dis 47(5): 642-650.
13. Fung CP, Chang Fy Fau - Lee, Lee SC et al (2002) A global emerging disease of Klebsiella pneumoniae liver abscess: is serotype K1 an important factor for complicated endophthalmitis? Gut 50(3): 420-424.
14. Lin JC, Chang FY, Fung CP, Xu JZ, Cheng HP, Wang JJ, Huang LY, Siu LK (2004) High prevalence of phagocytic-resistant capsular serotypes of Klebsiella pneumoniae in liver abscess. Microbes Infect 6(13): 1191-1198.
15. Fang CT, Chuang YP, Shun CT, Chang SC, Wang JT (2004) A novel virulence gene in Klebsiella pneumoniae strains causing primary liver abscess and septic metastatic complications. J Exp Med 199(5):697-5.
16. Sebghati TA, Korhonen TK, Hornick DB, Clegg S (1998) Characterization of the type 3 fimbrial adhesins of Klebsiella strains. Infect Immun 66(6): 2887-2894.
17. Fung CP, Lin YT, Lin JC et al (2012) Klebsiella pneumoniae in gastrointestinal tract and pyogenic liver abscess. Emerg Infect Dis 18(8): 1322-1325.
18. Thom BT (1970) Klebsiella in faeces. Lancet 2(7681): 1033.
19. Lin YT, Siu LK, Lin JC et al (2012) Seroepidemiology of Klebsiella pneumoniae colonizing the intestinal tract of healthy Chinese and overseas Chinese adults in Asian countries. BMC Microbiol 12:13. doi: 10.1186/1471-2180-12-13.
20. Sheu SJ, Kung YH, Wu TT et al (2011) Risk factors for endogenous endophthalmitis secondary to klebsiella pneumoniae liver abscess: 20-Year Experience in Southern Taiwan. Retina 31(10): 2026-2031.
21. Chee SP, Ang CL (1995) Endogenous Klebsiella endophthalmitis - a case series. Ann Acad Med Singap 24(3): 473-478.
2. Li F, Zheng W, Yu J et al (2022) Klebsiella pneumoniae liver abscess with purulent meningitis and endogenous endophthalmitis: A case report. Front Surg 9(1): 894929.
3. Liu JA-O, Dai M, Sun Q et al (2022) A typical multisite invasive infection caused by hvKP: A case report and literature review. Medicine (Baltimore) 101(52): 32592.
4. Saccente M (1999) Klebsiella pneumoniae Liver Abscess, Endophthalmitis, and Meningitis in a Man with Newly Recognized Diabetes Mellitus. Clin Infect Dis 29(6):1570-1571.
5. Nguyễn Thị Huyền Trang, Trần Thị Ánh Tuyết, Nguyễn Anh Tuấn và cộng sự (2024) Đặc điểm lâm sàng, cận lâm sàng ở bệnh nhân áp xe gan điều trị tại Bệnh viện Trung ương Quân đội 108. Tạp chí Y dược lâm sàng 108 19(1), tr. 40-47.
6. Pham Van Chung, Nguyen Thi Hiep, Hoang Dinh Nhu et al (2022) Clinical features, laboratory characteristics and treatment outcomes of liver abscess at the Institute of Clinical Infectious Diseases - 108 Military Central Hospital. Journal of 108 - Clinical Medicine and Phamarcy 17(52-8): 7.
7. Yu WL, Ko WC, Cheng KC, Lee HC, Ke DS, Lee CC, Fung CP, Chuang YC (2006) Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan. Clin Infect Dis 42(10): 1351-1358.
8. Fang CT, Lai SY, Yi WC, Hsueh PR, Liu KL, Chang SC (2007) Klebsiella pneumoniae genotype K1: An emerging pathogen that causes septic ocular or central nervous system complications from pyogenic liver abscess. Clin Infect Dis 45(3): 284-293.
9. Cong Long Nguyen, Truong Khanh Vu, Van Son Tran, et al (2022) Management of 96 Patients with Pyogenic Liver Abscess Admitted to a Single Hospital in Hanoi City, Vietnam, 2015-2020: Etiology, Drug Resistance, Complications, and the Outcomes. Biomed J Sci & Tech Res 42(4): 33922-33927.
10. Huynh Thanh Long, Khiem NM (2023) Clinical and laboratory characteristics of liver abscess patients at Nguyen Tri Phuong hospital. Vietnam Medical Journal 2(1): 130-138.
11. Nguyen L, Pham T, Luu D et al (2023) A retrospective study of endogenous endophthalmitis-related pyogenic liver abscess: An increasing complication in North Vietnam. SAGE Open Med 18(11): 1-5.
12. Lee SS, Chen YS, Tsai HC, Wann SR, Lin HH, Huang CK, Liu YC (2008) Predictors of septic metastatic infection and mortality among patients with Klebsiella pneumoniae liver abscess. Clin Infect Dis 47(5): 642-650.
13. Fung CP, Chang Fy Fau - Lee, Lee SC et al (2002) A global emerging disease of Klebsiella pneumoniae liver abscess: is serotype K1 an important factor for complicated endophthalmitis? Gut 50(3): 420-424.
14. Lin JC, Chang FY, Fung CP, Xu JZ, Cheng HP, Wang JJ, Huang LY, Siu LK (2004) High prevalence of phagocytic-resistant capsular serotypes of Klebsiella pneumoniae in liver abscess. Microbes Infect 6(13): 1191-1198.
15. Fang CT, Chuang YP, Shun CT, Chang SC, Wang JT (2004) A novel virulence gene in Klebsiella pneumoniae strains causing primary liver abscess and septic metastatic complications. J Exp Med 199(5):697-5.
16. Sebghati TA, Korhonen TK, Hornick DB, Clegg S (1998) Characterization of the type 3 fimbrial adhesins of Klebsiella strains. Infect Immun 66(6): 2887-2894.
17. Fung CP, Lin YT, Lin JC et al (2012) Klebsiella pneumoniae in gastrointestinal tract and pyogenic liver abscess. Emerg Infect Dis 18(8): 1322-1325.
18. Thom BT (1970) Klebsiella in faeces. Lancet 2(7681): 1033.
19. Lin YT, Siu LK, Lin JC et al (2012) Seroepidemiology of Klebsiella pneumoniae colonizing the intestinal tract of healthy Chinese and overseas Chinese adults in Asian countries. BMC Microbiol 12:13. doi: 10.1186/1471-2180-12-13.
20. Sheu SJ, Kung YH, Wu TT et al (2011) Risk factors for endogenous endophthalmitis secondary to klebsiella pneumoniae liver abscess: 20-Year Experience in Southern Taiwan. Retina 31(10): 2026-2031.
21. Chee SP, Ang CL (1995) Endogenous Klebsiella endophthalmitis - a case series. Ann Acad Med Singap 24(3): 473-478.
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Published
Apr 14, 2025
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How to Cite
ThấuN. S., NhànP. T. T., HươngB. T., & ChungP. V. (2025). Klebsiella pneumoniae Invasive Liver Abscess Syndrome (KILAS) with purulent meningitis and endophthalmitis: case report and literature review. Tạp Chí Y Dược lâm sàng 108, 20(2). https://doi.org/10.52389/ydls.v20i2.2642