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  1. Fulltext Double trouble: an unusual case of Klebsiella pneumoniae invasive syndrome with liver abscess, gallbladder empyema and infective endocarditis
    Lee ZC, Seow CE, Periyasamy P
    BMC Infect Dis, 2024 Aug 02;24(1):771.
    PMID: 39095695 DOI: 10.1186/s12879-024-09568-7
    BACKGROUND: Klebsiella pneumoniae invasive syndrome (KPIS) is characterized by primary pyogenic liver abscess associated with metastatic infections. Although rare, Klebsiella endocarditis carries a high mortality risk.

    CASE PRESENTATION: A 60-year-old lady with type II diabetes mellitus presented with fever, malaise, right hypochondriac pain and vomiting for two weeks. Ultrasound abdomen revealed a collection within liver, and distended gallbladder with echogenic debris within. 3 days after ultrasound guided pigtail drainage of gallbladder empyema, newly presence murmur detected. Pus, urine, and blood cultures obtained were positive for Klebsiella pneumonia. Echocardiogram exhibited oscillating mass attached to anterior mitral valve leaflet. After 6 weeks of intravenous ceftriaxone, follow-up echocardiogram and ultrasound showed complete resolution of mitral valve vegetation, hepatic and gallbladder collection.

    CONCLUSION: Concomitant extrahepatic infective endocarditis (IE) should raise concerns in daily practice for patients with Klebsiella pneumoniae liver abscesses, despite the rarity of Klebsiella endocarditis. In the absence of diagnostic suspicion, antibiotic treatment regimens may be shortened, and adverse effects from IE infection may ensue.

    Matched MeSH terms: Empyema/drug therapy
  2. Fulltext Empyema thoracis and lung abscess
    Yaacob I, Ariffin Z
    Singapore Med J, 1991 Feb;32(1):63-6.
    PMID: 2017709
    The case histories of 22 patients with lung abscess and empyema presenting to Hospital University Sains Malaysia (HUSM) between 1984 and 1989 are reviewed. The presenting features of both lung abscess and empyema were similar. The commonest predisposing factor was pneumonia, and the commonest organism isolated was Staphylococcus aureus but in the majority of cases, no causal organisms were identified. All the patients were treated with antibiotics and in addition, closed chest tube drainage was performed initially in all patients with empyema. Three patients with empyema required additional surgical drainage procedures. Death occurred in one patient with empyema and in one patient with lung abscess. The features, aetiology, treatment and outcome of thoracic empyema and lung abscess are discussed.
    Matched MeSH terms: Empyema/drug therapy
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