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Klebsiella Liver Abscess — RACP Adult Medicine MCQ

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ModerateInfectious DiseasesKlebsiella Liver AbscessRACP Adult Medicine

A 55-year-old diabetic man presents with fever (39.5°C), rigors, and right upper quadrant pain. CT shows a 6 cm unilocular liver abscess. Blood cultures grow Klebsiella pneumoniae. He has not travelled recently. Colonoscopy is unremarkable. What is the most likely diagnosis?

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Correct answer: B — Pyogenic liver abscess (Klebsiella)

Klebsiella pneumoniae pyogenic liver abscess is common in East Asian and diabetic populations. Unlike polymicrobial pyogenic abscesses (often from biliary or portal sources), K. pneumoniae liver abscess can occur without an obvious source (cryptogenic). Management: percutaneous drainage + IV antibiotics (ceftriaxone ± metronidazole for 4-6 weeks). Screen for K. pneumoniae endophthalmitis and meningitis (metastatic complications).

Reference: eTG Antibiotic – 2025 – Liver Abscess