Recurrent Liver Abscess Caused by Mucoid-Type Klebsiella pneumoniae Successfully Treated With Hepatic Artery Antibiotic Infusion Therapy: A Case Report

TL;DR

An 80-year-old woman with a recurring liver abscess caused by a rare type of bacteria was successfully treated with a less-invasive antibiotic therapy.

Contribution

Demonstrates the effectiveness of hepatic artery antibiotic infusion for treating refractory liver abscesses caused by mucoid-type Klebsiella pneumoniae.

Findings

Hepatic artery antibiotic infusion using cefmetazole led to a marked reduction in abscess size.

The treatment allowed a transition to oral antibiotics and complete resolution without surgery.

This approach offers a less-invasive alternative for complex liver abscess cases.

Abstract

Liver abscesses typically respond well to a combination of antibiotics and drainage. However, some cases can be resistant to treatment and pose a clinical challenge. Infections caused by mucoid-type Klebsiella pneumoniae are rare, but highly invasive, and can lead to conditions such as liver abscesses and hematogenous dissemination, resulting in systemic complications. Herein, we present the case of an 80-year-old woman with recurrent multilocular liver abscess caused by mucoid-type K. pneumoniae who was successfully treated with hepatic artery antibiotic infusion therapy. The patient was initially managed by percutaneous drainage and intravenous antibiotic administration, but the abscess relapsed despite multiple interventions. The patient was subsequently referred to our hospital for multidisciplinary treatment. Hepatic artery antibiotic infusion therapy using cefmetazole was chosen based on the patient's preference for a less-invasive approach. This treatment led to a marked reduction in abscess size, allowing a transition to oral antibiotics and achievement of complete resolution without the need for surgical intervention. This case highlights the effectiveness of hepatic artery antibiotic infusion as a less-invasive option for managing complex, refractory liver abscesses, providing an alternative to circumvent surgical intervention. Further research is needed to define the optimal use and indications for this approach.

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