• Zhoujia Yao, Jun Zheng, Youguang Si, and Wenhong Wang.
• HBP Department.
• Medicine (Baltimore). 2018 Nov 1; 97 (45): e13096e13096.

RationalePneumocardia and septic pulmonary embolism are uncommon complications of Klebsiella pneumoniae primary liver abscess (KPLA); however, they may lead to a poor clinical outcome.Patient ConcernsA 67-year-old woman was admitted to our hospital with fever, chills, cough, and dyspnea for 4 days. She had a previous history of diabetes mellitus.DiagnosesThe chest computed tomography (CT) revealed multiple peripheral nodules in both lungs and wedge-shaped peripheral infiltrative lesions abutting the pleura, suggestive of septic pulmonary embolism. An abdominal CT on the following day showed a large liver abscess without gas formation and pneumocardia of the right ventricle.InterventionsAfter the antibiotic therapy of intravenous imipenem and drainage of the liver abscess, our patient made a complete recovery.OutcomesThe patient was discharged on the 25th hospital day after full recovery and was doing well on follow-up at 10 months.LessonsKPLA is potentially fatal due to the associated serious metastatic complications. Attention must be paid not only to the primary focus of infection but also to infection of other organs. It is important to detect to diagnose the spread of infection accurately, in a timely manner, to improve the prognosis of this condition.

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