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Brain abscess due to Klebsiella pneumoniae in a liver‐transplanted child
Author(s) -
Vajro P.,
Sokal E.M.,
Maddaluno S.,
Esposito M.,
Caranci F.,
Capuano G.,
Caropreso M.,
Lenta S.
Publication year - 2009
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/j.1399-3062.2009.00395.x
Subject(s) - medicine , brain abscess , immunosuppression , klebsiella pneumoniae , abscess , liver transplantation , liver abscess , transplantation , complication , magnetic resonance imaging , antibiotics , pathology , surgery , radiology , biochemistry , chemistry , escherichia coli , biology , microbiology and biotechnology , gene
Brain abscesses are a rare, severe complication of orthotopic liver transplantation (OLT). They are almost exclusively due to fungi, Nocardia , or Toxoplasma , and usually occur within months of surgery. Here we report the case of an adolescent who developed a brain abscess due to Klebsiella pneumoniae 11.5 years after OLT. Fever was absent and laboratory parameters were not indicative of infectious disease, and therefore the diagnosis of a central nervous system neoplasm was considered. Subsequent magnetic resonance imaging and spectroscopy led to a diagnosis of a brain abscess, and to prompt appropriate antibiotic treatment. This case shows that K. pneumoniae may cause a brain abscess long after liver transplantation. The appearance of neurological symptoms should alert clinicians to consider a brain abscess even in the absence of overt clinical/laboratory signs of inflammation, which may be blunted by chronic immunosuppression.