Liver abscess in the caudate lobe caused by Klebsiella pneumoniae: a rare case report

Abstract Background Klebsiella pneumoniae (K. pneumoniae) liver abscesses are more likely to appear as single abscess cavity to involve single lobe of the liver, the right lobe affected more commonly. Liver abscess in the caudate lobe is rarely reported. Case presentation A 53-year-old man with chills and an intermittent high fever for the previous five days was admitted to our hospital. He had stable vital signs other than a tachycardia and fever at the time of presentation. Physical examination revealed tenderness over the right abdomen was elicited. The blood test showed a significant increase in C reactive protein (234.35mg/L), procalcitonin(57.62ng/mL), white blood cell counts (17.77×109/L ) and cLac(2.9mmol/L). His platelet count was 18×109/L. Computed tomographic (CT) scan of the lung demonstrated that there were multiple nodules and patchy shadows in each lobe of both lungs. A low-density area was observed in the caudate liver lobe on the liver CT scan. Klebsiella pneumoniae was isolated from sputum, urine and blood. With the suspicion of liver abscesses, invasive liver abscess syndrome (ILAS) and septic shock. The patient was successful treated with empirical antibiotics. He returned to close to his premorbid function. Conclusion This is the first detailed report of liver abscess in the caudate liver lobe caused by K. pneumoniae.