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Septic Metastatic Lesions Associated with Klebsiella pneumoniae Liver Abscess
Jong Young Lee, M.D., Byung Kyu Nah, M.D., Ji Hoon Kim, M.D., Se Hyeung Lee, M.D.Tae Hyuck Choi, M.D., Hye Young Choi, M.D., Kwang Seok Kim, M.D. and Gab Jin Cheon, M.D.
Departement of Internal Medicine, Gangneung Asan Medical Center, University of Ulsan College of Medicine, Gangneung, Gangwon-do, Korea
Vol.38 Num.2 (p95~100)
Pyogenic liver abscess is a serious clinical disease with severe complication in about 10-20% of cases. Metastatic septic endophthalmitis and CNS infection are rare but their incidence is increasing in liver abscess patients, especially Klebsiella pneumoniae as etiologic bacteria. Despite appropriate treatment, the outcome is devastating. We experienced a case of septic endophthalmitis, CNS infection (meninigitis, ventriculitis) and infective spondylitis associated with K. pneumoniae liver abscess. The patient had no specific risk factor. After intensive treatement such as systemic intravenous antibiotics with percutaneous abscess drainage and intravitreal injection, liver abscess was resolved completely. But, sequelae were severe. Socket reconstruction after evisceration with debridement on both eye and ventriculo-peritoneal shunt due to hydrocephalus were done. Our experience suggests that attention should be paid to the possibility of septic metastatic lesions as soon as the treatment of K. pneumoniae liver abscess is initiated.
Keywords : Liver abscess, Meningitis, Klebsiella pneumoniae, Endophthalmitis, Infective spondylitis