PMC3229087_01
String test result for Klebsiella pneumoniae. Stretching of K. pneumoniae colonies isolated from our patient's sample resulted in the formation of a string >5 mm in length, demonstrating the hypermucoviscosity phenotype.
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F1
Hypermucoviscous phenotype was confirmed by a positive string test: formation of viscous strings >= 5 mm in length when a standard bacteriologic loop was used to stretch the colony on agar plate Fig. (1).
Abdominal Computed Tomography (CT) scan images a) CT showing a 15 cm diameter liver abscess with internal septa and irregular margins.
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F2a
Abdominal computed tomography (CT) scan with double contrast showed a 15 cm hypodense lesion with internal septa in the liver Fig. (2a), and a hypodense tumour-like lesion with narrowing of the gastric lumen Fig. (2b).
CT hypodensity tumour like lesion with narrowing of the gastric lumen (gastric abscess).
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The latter was further investigated by endoscopy-ultrasound (EUS), which showed a 3-cm well-circumscribed hypoechoic submucosal mass suggestive of intramural gastric abscess Fig. (3a,b).  Chest x-ray, transthoracic echocardiography and abdominal Doppler ultrasound were normal.
Endoscopy showing submucosal mass
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F3a
All strains from different isolation sites were serotype K1 by PCR and had identical profile by PFGE Fig. (4).
Endoscopy-ultrasound demonstrating a 3-cm well circumscribed hypoechoic submucosal mass suggestive of intramural abscess.
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F3b
All strains were positive for rmpA, wzyKpK1 and aerobactin genes as revealed by PCR using specific primers Fig. (5), Fig. (6).