Vasculitic Rash: A Rare Complication of Klebsiella Liver Abscess in Uncontrolled Diabetes

TL;DR

A rare case of vasculitic rash caused by a Klebsiella liver abscess in a diabetic patient is reported, emphasizing the need for accurate diagnosis to avoid harmful treatments.

Contribution

Reports a rare cutaneous manifestation of Klebsiella pneumoniae liver abscess in uncontrolled diabetes.

Findings

A diabetic patient developed a vasculitic rash due to Klebsiella liver abscess.

Blood cultures confirmed Klebsiella pneumoniae as the causative agent.

Successful treatment involved drainage and antibiotics, avoiding immunosuppression.

Abstract

Klebsiella pneumoniae liver abscess (KPLA) is a known complication in patients with poorly controlled diabetes mellitus, frequently resulting in bacteremia and metastatic infections. However, cutaneous manifestations, such as vasculitic rash, are exceedingly rare. We present a case of a 45-year-old male with uncontrolled diabetes who was admitted with high-grade fever, rigors, and dyspnea. Within 24 h of admission, he developed a bilateral, purpuric, non-blanching rash on the lower limbs suggestive of vasculitis. Laboratory investigations revealed a negative vasculitis screen and positive blood cultures for Klebsiella pneumoniae (K. pneumoniae). Computed tomography of the abdomen identified a large subcapsular liver abscess. The patient was successfully treated with percutaneous radiologically guided drainage and broad-spectrum antibiotics. This case highlights that clinicians should consider infectious etiologies, such as K. pneumoniae in vasculitic rashes among diabetic patients, as misdiagnosis and inappropriate immunosuppression can worsen outcomes.

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