Abstract
The Cryptogenic Invasive Liver Abscess Syndrome is a complication of primary Klebsiella pneumoniae liver abscesses. Determined by septic metastatic dissemination to extrahepatic loci such as the lung, eye or CNS, it associates high morbidity but low mortality. Initially described in Taiwan in 1986, it is practically limited to Southeast Asia. However, recently it has been increasingly documented in non-Asian populations and in other global regions, with rising incidence. We hereby report the case of a young male without Asian ascendancy presenting with high fever, generalized myalgias, unspecified abdominal pain and total amaurosis of the left eye. Upon testing, a K. pneumoniae cryptogenic liver abscess is detected with associated pulmonary septic emboli, endogenous endophthalmitis and a gluteal abscess.
References
Fazili T, Sharngoe C, Endy T, Kiska D, Javaid W, Polhemus M. Klebsiella pneumoniae Liver Abscess: An Emerging Disease. Am J Med Sci. 2016 Mar;351(3):297-304. DOI: 10.1016/j.amjms.2015.12.018. PMID: 26992260.
Rahimian J, Wilson T, Oram V, Holzman RS. Pyogenic liver abscess: recent trends in etiology and mortality. Clin Infect Dis. 2004 Dec 1;39(11):1654-9. DOI: 10.1086/425616. PMID: 15578367.
Braiteh F, Golden MP. Cryptogenic invasive Klebsiella pneumoniae liver abscess syndrome. Int J Infect Dis. 2007 Jan;11(1):16-22. DOI: 10.1016/j.ijid.2005.10.006. PMID: 16473034.
Siu LK, Yeh KM, Lin JC, Fung CP, Chang FY. Klebsiella pneumoniae liver abscess: a new invasive syndrome. Lancet Infect Dis. 2012 Nov;12(11):881-7. DOI: 10.1016/S1473-3099(12)70205-0. PMID: 23099082.
Hussain I, Ishrat S, Ho DCW, Khan SR, Veeraraghavan MA, Palraj BR, Molton JS, Abid MB. Endogenous endophthalmitis in Klebsiella pneumoniae pyogenic liver abscess: Systematic review and meta-analysis. Int J Infect Dis. 2020 Dec;101:259-268. DOI: 10.1016/j.ijid.2020.09.1485. PMID: 33035676.
Molton JS, Chan M, Kalimuddin S, Oon J, Young BE, Low JG, Salada BMA, Lee TH, Wijaya L, Fisher DA, Izharuddin E, Koh TH, Teo JWP, Krishnan PU, Tan BP, Woon WWL, Ding Y, Wei Y, Phillips R, Moorakonda R, Yuen KH, Cher BP, Yoong J, Lye DC, Archuleta S. Oral vs Intravenous Antibiotics for Patients With Klebsiella pneumoniae Liver Abscess: A Randomized, Controlled Noninferiority Study. Clin Infect Dis. 2020 Aug 14;71(4):952-959. DOI: 10.1093/cid/ciz881. PMID: 31641767.

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