Liver Abscess Metastatic Syndrome Caused by Hypermucoviscous Klebsiella Pneumoniae in a Canadian Patient of Vietnamese Origin

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Sandra Patricia Criales Doria http://orcid.org/0000-0001-9048-7665
Alexandre Lafleur
Philippe Gervais

Keywords

Klebsiella pneumoniae, liver abscess

Abstract

Klebsiella pneumoniae liver abscess syndrome (KLAS) is an emerging infection caused by hypermucoviscous strains (K1, rmpA, mgA) with a particular virulence at risk of metastatic dissemination. We describe a case of metastatic KLAS in a Canadian immunocompetent patient of Vietnamese origin who presented with fever and abnormal liver function tests. Imaging studies revealed unique liver and pulmonary abscesses. Blood and liver abscess cultures showed colonies of K.pneumoniae with hypermucoviscous phenotype, a K1 serotype and the presence of a rmpA gene confirming biomolecular features of the invasive syndrome. Mostly reported in patients of Asian origin, KLAS has been reported in Canada since 2007. Prompt identification and treatment prevents severe complications such as endophthalmitis, meningitis, lung abscess and spondylodiscitis.

 

Résumé:

Le syndrome d’abcès hépatique à Klebsiella pneumoniae (KLAS en anglais) est une infection en émergence résultant d’une souche hypermuqueuse (K1, rmpA, mgA) d’une virulence accrue, à risque de dissémination. Nous décrivons un cas de KLAS métastatique chez un patient canadien d’origine vietnamienne, immunocompétent, qui présentait de la fièvre et des anomalies du bilan hépatique. Les imageries ont révélé des abcès hépatiques et pulmonaires uniques.  Les hémocultures et les cultures du drainage de l’abcès hépatique ont confirmé la présence d’une souche hypermuqueuse de Klebsiella pneumoniae, sérotype K1, génotype rmpA, caractéristiques biomoléculaires associées aux infections invasives. Principalement décrits chez des patients d’origine asiatique, des cas de KLAS sont rapportés au Canada depuis 2007. L’identification et le traitement rapide préviendront des complications sévères, dont l’endophtalmite, la méningite, l’abcès pulmonaire et la spondylodiscite.

 

 

 

 

 

 

 


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