Protean neuroimaging presentations in an adult with Klebsiella pneumoniae infection

Purpose: To report on the findings of a series of cranial computed tomography (CT) and magnetic resonance (MR) imaging studies of a 57-years-old woman with Klebsiella (K.) pneumoniae infection. Case report: The patient had fever, consciousness disturbance and left hemiplegia as the initial presentations of K. pneumoniae infection. Initial blood culture grew K. pneumoniae, and a delayed purulent cerebrospinal fluid profile was found later. The serial neuroimaging studies showed cerebral hemorrhage, cerebritis and subsequent multiple abscess formations. In the meanwhile hepatic and pulmonary abscess were also discovered by imaging studies. With a 77- days intravenous ceftriaxone treatment (4 gm/day), the abscess formations of brain, lung and liver were all resolved. Conclusion: This study showed the protean neuroimage features of a woman with K. pneumoniae infection and the confirmation of multiple brain abscesses was made by follow-up neuroimaging studies. These sequential neuroimage findings in one patient are uncommon but deserved special clinical note by the first-line, primary-care physicians including neurologists.