# Retroperitoneal Abscess Due to Klebsiella pneumoniae Treated With Multiple Percutaneous Catheter Drainages in a Patient With Diabetes: A Case Report

## TL;DR

A diabetic patient developed a rare retroperitoneal abscess caused by Klebsiella pneumoniae, successfully treated with catheter drainage and antibiotics.

## Contribution

This case report highlights the effective use of multiple percutaneous catheter drainages in treating a rare and severe infection in a diabetic patient.

## Key findings

- A 60-year-old diabetic woman was successfully treated for a retroperitoneal abscess using percutaneous catheter drainage and antibiotics.
- Klebsiella pneumoniae was identified as the causative pathogen, which is more common in immunocompromised individuals like those with diabetes.
- Early diagnosis and intervention significantly improved the patient's clinical outcome and reduced morbidity.

## Abstract

Retroperitoneal abscesses are rare but serious clinical conditions characterized by delayed diagnosis, insufficient drainage, and high morbidity. They are more common in immunocompromised individuals, such as those with diabetes mellitus.

A 60-year-old female with a history of type 2 diabetes mellitus presented with complaints of right flank pain, nausea, and vomiting. Laboratory tests revealed leukocytosis, and abdominal imaging identified a 10 cm abscess in the right retroperitoneal space. Percutaneous drainage was performed with a pigtail catheter under ultrasound guidance. Klebsiella pneumoniae was isolated from the abscess culture. Clinical improvement was observed during follow-up. The patient received meropenem and cefazolin for a total duration of four weeks. Upon clinical improvement, she was discharged.

Retroperitoneal abscesses often present with nonspecific symptoms, leading to delays in diagnosis. In patients with diabetes, the risk of severe infections with Gram-negative pathogens like Klebsiella pneumoniae is elevated due to impaired immune response. Early imaging, timely percutaneous drainage, and appropriate antibiotics are crucial for effective management.

Retroperitoneal abscesses should be considered in patients with diabetes presenting with abdominal pain and systemic symptoms. Prompt diagnosis and early intervention significantly reduce morbidity and improve outcomes.