Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Klebsiella pneumoniae liver abscess in an immunocompetent child

  • Kwon, Jang-Mi (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Jung, Hye Lim (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Shim, Jae Won (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Deok Soo (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Shim, Jung Yeon (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Park, Moon Soo (Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • Received : 2012.11.21
  • Accepted : 2013.01.29
  • Published : 2013.09.15
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Abstract

Klebsiella pneumoniae has emerged as a leading pathogen that causes pyogenic liver abscesses (PLAs) in Korea. K. pneumoniae liver abscess (KLA) is potentially life threatening, and the diagnosis is difficult. In developed countries, PLA is rarely observed in children and is frequently associated with disorders of granulocyte function and previous abdominal infection. We observed a case of KLA in a healthy 12-year-old boy. To our knowledge, this is the first reported case of KLA in an immunocompetent child without an underlying disease in Korea. The patient was treated with percutaneous catheter drainage and antibiotics. The catheter was placed in the intrahepatic abscess for 3 weeks and parenteral antibiotics (ceftriaxone and amikacin) were administered for 4 weeks, followed by oral antibiotics (cefixime) for 2 weeks. We reported this case to raise awareness of KLA in immunocompetent children among physicians, and to review the diagnosis, risk factors, potential complications, and appropriate treatment of KLA.

Keywords

References

  1. Muorah M, Hinds R, Verma A, Yu D, Samyn M, Mieli-Vergani G, et al. Liver abscesses in children: a single center experience in the developed world. J Pediatr Gastroenterol Nutr 2006;42:201-6. https://doi.org/10.1097/01.mpg.0000189344.23387.26
  2. Kaplan GG, Gregson DB, Laupland KB. Population-based study of the epidemiology of and the risk factors for pyogenic liver abscess. Clin Gastroenterol Hepatol 2004;2:1032-8. https://doi.org/10.1016/S1542-3565(04)00459-8
  3. Pineiro-Carrero VM, Andres JM. Morbidity and mortality in children with pyogenic liver abscess. Am J Dis Child 1989;143:1424-7.
  4. Kong MS, Lin JN. Pyogenic liver abscess in children. J Formos Med Assoc 1994;93:45-50.
  5. Chung DR, Lee SS, Lee HR, Kim HB, Choi HJ, Eom JS, et al. Emerging invasive liver abscess caused by K1 serotype Klebsiella pneumoniae in Korea. J Infect 2007;54:578-83. https://doi.org/10.1016/j.jinf.2006.11.008
  6. Chung DR, Lee HR, Lee SS, Kim SW, Chang HH, Jung SI, et al. Evidence for clonal dissemination of the serotype K1 Klebsiella pneumoniae strain causing invasive liver abscesses in Korea. J Clin Microbiol 2008;46:4061-3. https://doi.org/10.1128/JCM.01577-08
  7. Chan KS, Yu WL, Tsai CL, Cheng KC, Hou CC, Lee MC, et al. Pyogenic liver abscess caused by Klebsiella pneumoniae: analysis of the clinical characteristics and outcomes of 84 patients. Chin Med J (Engl) 2007;120:136-9.
  8. Kuo CM, Kuo CH, Changchien CS. Liver abscess in patients with cirrhosis of the liver: a 12-year experience. J Gastroenterol 2001; 36:552-6. https://doi.org/10.1007/s005350170058
  9. Seeto RK, Rockey DC. Pyogenic liver abscess. Changes in etiology, management, and outcome. Medicine (Baltimore) 1996;75:99-113. https://doi.org/10.1097/00005792-199603000-00006
  10. Rahimian J, Wilson T, Oram V, Holzman RS. Pyogenic liver abscess: recent trends in etiology and mortality. Clin Infect Dis 2004; 39:1654-9. https://doi.org/10.1086/425616
  11. Okano H, Shiraki K, Inoue H, Kawakita T, Yamamoto N, Deguchi M, et al. Clinicopathological analysis of liver abscess in Japan. Int J Mol Med 2002;10:627-30.
  12. Lee KT, Wong SR, Sheen PC. Pyogenic liver abscess: an audit of 10 years' experience and analysis of risk factors. Dig Surg 2001;18:459-65. https://doi.org/10.1159/000050194
  13. Yang CC, Chen CY, Lin XZ, Chang TT, Shin JS, Lin CY. Pyogenic liver abscess in Taiwan: emphasis on gas-forming liver abscess in diabetics. Am J Gastroenterol 1993;88:1911-5.
  14. Cheng DL, Liu YC, Yen MY, Liu CY, Shi FW, Wang LS. Pyogenic liver abscess: clinical manifestations and value of percutaneous catheter drainage treatment. J Formos Med Assoc 1990;89:571-6.
  15. Lederman ER, Crum NF. Pyogenic liver abscess with a focus on Klebsiella pneumoniae as a primary pathogen: an emerging disease with unique clinical characteristics. Am J Gastroenterol 2005;100:322-31. https://doi.org/10.1111/j.1572-0241.2005.40310.x
  16. Cheng DL, Liu YC, Yen MY, Liu CY, Wang RS. Septic metastatic lesions of pyogenic liver abscess. Their association with Klebsiella pneumoniae bacteremia in diabetic patients. Arch Intern Med 1991;151:1557-9. https://doi.org/10.1001/archinte.1991.00400080059010
  17. Barton EN, Daisley H, Gilbert DT, Roberts L. Diabetes mellitus and Klebsiella pneumoniae liver abscess in adults. Trop Geogr Med 1991;43:100-4.
  18. Lorenz J, Thomas JL. Complications of percutaneous fluid drainage. Semin Intervent Radiol 2006;23:194-204. https://doi.org/10.1055/s-2006-941450
  19. Johannsen EC, Sifri CD, Madoff LC. Pyogenic liver abscesses. Infect Dis Clin North Am 2000;14:547-63. https://doi.org/10.1016/S0891-5520(05)70120-3
  20. Pope JV, Teich DL, Clardy P, McGillicuddy DC. Klebsiella pneumoniae liver abscess: an emerging problem in North America. J Emerg Med 2011;41:e103-5. https://doi.org/10.1016/j.jemermed.2008.04.041
  21. Jung DY, Lee SJ, Lee MH, Choi DY, Park SK, Yoon HS, et al. case of pyogenic liver abscess with spontaneous subcapsularhemorrhage. Korean J Gastroenterol 2001;38:449-452.
  22. Kim YS, Gang YS, Jung JH, Park KO, Kim SM, Lee BS, et al. Septic metastatic bilateral endophthalmitis complicating Klebsiella pneumoniae liver abscess in a non-diabetic woman. Korean J Med 2005; 68:233-7.

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