Pyogenic Liver Abscess and Endogenous Endophthalmitis Due to K64-ST1764 Hypervirulent : A Case Report.

RATIONALE

(, KP) are divided into two types: classic (cKP) and hypervirulent (hvKP). hvKP causes liver abscess and metastatic infection. Here, we report one case with pyogenic liver abscess (PLA) and endogenous endophthalmitis (EE) due to a relatively rarely reported serotype of in China.

PATIENT CONCERNS

An 80-year old man presented with nausea, vomiting, and epigastric discomfort for 2 weeks.

DIAGNOSES

PLA was identified by CT scan and abdominal ultrasound. Urgent ophthalmologic consultation was performed. B-scan ocular ultrasound was done and he was diagnosed as EE.

INTERVENTIONS

Antibiotic treatment, intravitreal injection of eyes and eye drops were given. Percutaneous needle aspiration, evisceration, and drainage of the right eye were performed.

OUTCOMES

Cultures of the blood, the aspirated pus from the liver abscess, and the contents of the eyeball all yielded with a positive string test. The capsular serotype was K64. According to the existence of multiple virulence genes and the severe invasive clinical manifestation, this strain is regarded as a hvKp strain. Multilocus sequence typing (MLST) revealed the sequence type (ST) of this strain was K64-ST1764. Antimicrobial resistance genes, and , were not detected in the genome. The patient lost his eyesight but his symptoms subsided. During 15 months follow-up, the result was satisfactory.

LESSONS

Here, we report one case with PLA due to a relatively rarely reported serotype of in China. This K64 strain is confirmed as hvKp by multiple methods. It is noteworthy that the sequence type is K64-ST1764 instead of the commonest ST11. Moreover, this strain is not considered a carbapenemase-producing (KPC-Kp) or a carbapenem-resistant (CRKP) as it is usually. Further follow-up and research are required to investigate this strain.