Klebsiella and E. coli liver abscess associated with aerobilia: a case report

Pyogenic liver abscesses are commonly caused by biliary tract infections. We report here a case of liver abscess developed secondary to a biliary-enteric fistula. A 83 year old diabetic woman was admitted because of sepsis due to Klebsiella pneumoniae and E. Coli and with upper right quadrant pain. Six months before admission, a laparoscopic cholecystectomy was performed. The abdominal sonography showed a liver abscess associated with an important aerobilia. The Magnetic Resonance Cholangiography showed a choledocho-colic fistula with an important inflammatory background. There was no evidence of neoplasia or inflammatory bowel disease. The evolution was marked by the development of urinary and bronchial tract infection due to Klebsiella. Septic metastasis are characteristics of Klebsiella liver abscesses. Percutaneous drainage associated with a intravenous antibiotherapy was performed.