I read with interest the article by Pope et al. on Klebsiella spp.-related pyogenic liver abscess (PLA) and the threat this organism poses for emergency physicians in the West (
1). By and large, clinicians in the West are still relatively unfamiliar with infections caused by Klebsiella spp., including PLA. There are now increasing numbers of reports in the West (
- Pope J.V.
- Teich D.L.
- Clardy P.
- McGillicuddy D.C.
Klebsiella pneumoniae liver abscess: an emerging problem in North America.
J Emerg Med. 2008 Nov 6; ([Epub ahead of print])
- Lederman E.R.
- Crum N.F.
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: 322-331
- Braiteh F.
- Golden M.P.
Cryptogenic invasive Klebsiella pneumoniae liver abscess syndrome.
Int J Infect Dis. 2007; 11 (Epub 2006 Feb 10): 16-22
4). Literature on Klebsiella spp.-related PLA has originated mostly from the East, where clinicians are more familiar with this infection. Klebsiella spp.-related sepsis typically occurs in patients with underlying disorders such as diabetes mellitus or other immune-compromising disorders. In Klebsiella-related PLA, it is not uncommon for patients to have multiple abscesses. In addition, metastatic infective foci are often reported (
- Keynan Y.
- Karlowsky J.A.
- Walus T.
- Rubinstein E.
Pyogenic liver abscess caused by hypermucoviscous Klebsiella pneumoniae.
Scand J Infect Dis. 2007; 39: 828-830
- Yang P.W.
- Lin H.D.
- Wang L.M.
Pyogenic liver abscess associated with septic pulmonary embolism.
J Chin Med Assoc. 2008; 71: 442-447
6). Delay in diagnosis and appropriate treatment can lead to poor outcomes.
- Cheng D.L.
- Liu Y.C.
- Yen M.Y.
- Liu C.Y.
- Wang R.S.
Septic metastatic lesions of pyogenic liver abscess Their association with Klebsiella pneumoniae bacteremia in diabetic patients.
Arch Intern Med. 1991; 151: 1557-1559
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- Klebsiella pneumoniae liver abscess: an emerging problem in North America.J Emerg Med. 2008 Nov 6; ([Epub ahead of print])
- 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: 322-331
- Cryptogenic invasive Klebsiella pneumoniae liver abscess syndrome.Int J Infect Dis. 2007; 11 (Epub 2006 Feb 10): 16-22
- Pyogenic liver abscess caused by hypermucoviscous Klebsiella pneumoniae.Scand J Infect Dis. 2007; 39: 828-830
- Pyogenic liver abscess associated with septic pulmonary embolism.J Chin Med Assoc. 2008; 71: 442-447
- Septic metastatic lesions of pyogenic liver abscess.Arch Intern Med. 1991; 151: 1557-1559
- Melioidosis.Lancet. 2003; 361: 1715-1722
- Melioidosis outbreak after typhoon, southern Taiwan.Emerg Infect Dis. 2007; 13: 896-898
- Melioidosis: an emerging infection in Taiwan?.Emerg Infect Dis. 2001; 7: 428-433
Published online: January 18, 2010
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