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(hvKP) strains can cause invasive liver abscess syndrome, which is characterised by liver abscess with extrahepatic compli-cations including central nervous system involvement, necrotising fasciitis or endophthalmitis (Siu et al. 2012). hvKP was first reported in Taiwan in 1985 and, since then, infections caused by hvKP have been described in several parts of the world, with many cases reported in Southeast Asia (Li et al. 2014). In the Americas, in-vasive liver abscess syndrome has been reported in the United States of America, Canada and Argentina (Siu et al. 2012). However, this strain has not been previously reported in Brazil. Recently, a 57-year-old woman with diabetes mellitus was admitted to the emergency de-partment with a history of fever, nausea, vomiting and mental confusion for five days. On the day of admission, she was comatose, icteric and had a poor general appear-ance. Her temperature was 37.8°C and her blood pres-sure, pulse and respiratory rate were 110/60 mmHg, 96 beats/min and 48 breaths/min, respectively. Respiratory and cardiovascular auscultations were normal; however, a neurological examination revealed neck rigidity. Bac-terial meningitis was suspected and ceftriaxone 2 g IV q12 h was empirically prescribed after performing a di-agnostic lumbar puncture. Her cerebrospinal fluid (CSF) was xanthochromic and showed glucose 0.0 mg/dL, pro-tein 485 mg/dL and 8,640 cells/mm

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Community-acquired invasive liver abscess syndrome caused by a K1 serotype Klebsiella pneumoniae isolate in Brazil: a case report of hypervirulent ST23