CASE REPORT article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1605284
Recurrent Invasive Liver Abscess Syndrome Induced by Klebsiella pneumoniae with Emerging Drug Resistance: A Case Report and Literature Review
Provisionally accepted
- 1Department of Clinical Pharmacy, Qingdao Chengyang District People’s Hospital, Qingdao, Shandong Province, China
- 2Qilu Hospital of Shandong University (Qingdao), Qingdao, China
- 3Department of Pharmacy, Qilu Hospital of Shandong University (Qingdao), Qingdao, China
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Invasive liver abscess syndrome (ILAS) caused by hypervirulent Klebsiella pneumoniae (hvKp) is a life-threatening infection associated with high mortality, particularly when complicated by brain abscesses. The emergence of carbapenem-resistant hypervirulent K. pneumoniae (CR-hvKp) during treatment, driven by emerging resistance, poses significant therapeutic challenges.We describe a 70-year-old diabetic male with recurrent ILAS who developed sequential multi-organ infections, including urinary tract infection, bacteremia, lung abscess, and brain abscess. Initial isolates were identified as carbapenem-susceptible; however, under prolonged antimicrobial pressure, they were transformed into CR-hvKp carrying the KPC gene. Treatment evolution escalated from meropenem to ceftazidime-avibactam plus tigecycline, resulting in clinical improvement and discharge after 48 days.This case highlights the critical challenge of emerging resistance in hvKp during prolonged therapy, emphasizing the need for early molecular surveillance, multidisciplinary collaboration, and optimized antibiotic stewardship to mitigate treatment failure in ILAS.
Keywords: invasive liver abscess syndrome, Emerging drug resistance, Brain Abscess, Klebsiella pneumoniae, case reprot
Received: 03 Apr 2025; Accepted: 14 Jul 2025.
Copyright: © 2025 Li, He, Wu, Li and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chengcheng Wang, Department of Pharmacy, Qilu Hospital of Shandong University (Qingdao), Qingdao, China
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