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Ann Geriatr Med Res > Volume 17(4); 2013 > Article
Journal of the Korean Geriatrics Society 2013;17(4):239-243.
DOI: https://doi.org/10.4235/jkgs.2013.17.4.239    Published online December 31, 2013.
Klebsiella pneumoniae Liver Abscess Complicated With Septic Pulmonary Embolism
Jae Ryung Yi, Yeop Yoon, Yu Na Jung, Hee Sook Lee, Gi Ho Jo, Ina Jeong
Departments of 1Internal Medicine and 2Radiology, National Medical Center, Seoul, Korea
노인 환자에서 Klebsiella pneumoniae 간농양에 합병된
감염성 폐 색전증 1예
이재령1⦁윤 엽2⦁정유나1⦁이희숙1⦁조기호1⦁정인아1
국립중앙의료원 내과1, 영상의학과2
Abstract
Klebsiella pneumoniae has been reported to be the most common pathogen causing pyogenic liver abscess. K. pneumoniae liver abscess occurs fairly often in patients with diabetes mellitus, and is commonly associated with metastatic infections such as brain abscess, endophthalmitis, lung abscess, osteomyelitis, prostatitis, necrotizing fasciitis and infection in other sites. Although septic pulmonary embolism (SPE) is uncommon, it is a serious metastatic complication of K. pneumoniae liver abscess. Chest computed tomography (CT) scans are crucial in making the early diagnosis of SPE; however, it does not provide the basis for a definitive diagnosis. A 70-year-old man was referred to the Department of Pulmonology due to cough and an abnormal chest radiography. The chest CT scans revealed relatively well-demarcated, round multiple nodules with peripheral preponderance, cavitary mass in the right upper lobe of the lung and low-density hepatic cystic masses. Bronchoscopic examination and percutaneous needle aspiration of the lung were performed, but there was no evidence of malignancy. Finally, K. pneumoniae was grown from a bronchial washing specimen and blood culture. Intravenous carbapenem was administered over a 3-week period and follow-up CT scans showed improvement in both the lung and the liver. We report a case of K. pneumoniae liver abscess complicated with SPE requiring differential diagnosis of hematogenous metastatic malignancy on CT scans in an elderly patient.
Key Words: Klebsiella pneumoniae, Liver abscess, Septic pulmonary embolism, Aged


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