Klebsiella pneumoniae-induced liver abscess in a patient with ulcerative colitis: a case report and review of the literature

BACKGROUND: Hepatic abscess represents an exceptionally rare extraintestinal complication of ulcerative colitis, with only 11 cases reported in literature to date. CASE PRESENTATION: We describe a 43-year-old Chinese woman with ulcerative colitis who developed a hepatic abscess secondary to Klebsiella pneumoniae infection. The diagnosis was confirmed by microbiological isolation of Klebsiella pneumoniae from both blood and abscess cultures. The patient received a combined therapeutic strategy involving culture-directed antibiotics and optimization of ulcerative-colitis-specific treatment, resulting in complete clinical resolution and no recurrence over a 5-year longitudinal follow-up. CONCLUSION: This case describes a Klebsiella pneumoniae-associated hepatic abscess in a patient with ulcerative colitis, a combination not previously reported in literature. This case highlights the extraordinary rarity of Klebsiella pneumoniae-associated hepatic abscesses in ulcerative colitis populations. Clinicians should consider this diagnosis in patients with ulcerative colitis presenting with right upper quadrant pain accompanied by pyrexia, even in the absence of classic risk factors. Expedited abdominal imaging and targeted antimicrobial therapy are essential to prevent systemic complications.