PMC8460774_01
MRI or CT scan images of the patient. (A,B) indicated partial enhancement of pia mater in brain enhanced MRI; (C,D) revealed an area of abnormal attenuation measuring 67 mm x 62 mm in the right lobe of the liver, indicative of a single large multi-loculated abscess in abdominal enhanced CT; (E) displayed the abscess reduced to 51 mm x 37 mm 3 days after emergency CT-guided percutaneous drainage of the liver abscess in abdominal plain CT; (F) showed no lesions in liver in the reexamination of abdominal CT after full recovery.
fmed-08-714916-g0001.jpg
PMC8460774_01_fmed-08-714916-g0001.jpg
F1
On the second day of hospitalization, a brain MRI scan was performed, and partial enhancement of the pia mater was recommended (Figures 1A,B). An abdominal enhanced CT demonstrated a single abscess (67 mm x 62 mm) in the right lobe of the liver with separating enhancement (Figures 1C,D) and confirmed our suspicion. Reexamination of abdominal CT suggested the liver abscess was reduced to 51 mm x 37 mm (Figure 1E). The patient underwent abdominal CT again, which showed no lesions in her liver (Figure 1F) at the second follow-up after 9 months.
mNGS results of pathogen identification: 47.7 and 42.56% of bacterial reads corresponded to K. pneumoniae with coverage of 15.2653 and 4.1186% in CSF (A) and blood (B), respectively.
fmed-08-714916-g0002.jpg
PMC8460774_01_fmed-08-714916-g0002.jpg
F2
Klebsiella pneumoniae, with a total of 13,470 detected unique reads detected (Figure 2A). Klebsiella pneumoniae invasive liver abscess syndrome was suspected as the clinical features and unusual findings of the pathogen in this patient. Meanwhile, the blood mNGS results demonstrated 5,318 unique reads of Klebsiella pneumoniae (Figure 2B).