Hepatic abscess – clinical aspects of Klebsiella infection – a case report

Case report A 61-year-old patient from Lugoj was admitted accusing fever, chills and dysuria for approximately 3 days. He was first diagnosed with diabetes mellitus, which required high insulin doses for correction. Clinical and laboratory findings demonstrated sepsis (fever, chills, leukocytosis and neutrophilia, high glycemic levels, renal failure). X-ray and echography were normal. Blood cultures were negative; however, urine culture was positive for Klebsiella. He was administered ceftriaxone and gentamicin i.v., according to the antibiotic susceptibility tests. Unfortunately, during admission, jaundice, high ALT, AST and cholestasis complicated the case. CT scan revealed a trans-sonic inhomogeneous image suggesting a hepatic abscess, therefore the patient was sent to immediate surgery, which revealed a pyogenic collection. Cultures were positive for Klebsiella. The postoperative evolution slowly improved only after local drainage and antibiotics.