J Neurosonol Neuroimag.  2022 Dec;14(2):99-103. 10.31728/jnn.2022.00130.

Klebsiella pneumoniae Cerebritis Masquerading as Hyperacute Middle Cerebral Artery Syndrome

Affiliations
  • 1Department of Neurology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
  • 2Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea

Abstract

Several clinical syndromes can present with the symptoms or signs resembling an acute stroke. A 52-year-old woman with uncontrolled diabetes presented with symptoms of a hyperacute right middle cerebral artery (MCA) stroke. However, there was a discrepancy between the patient’s clinical symptoms and the multimodal neuroimaging findings. Further diagnostic workup confirmed bacteremia and cerebritis caused by Klebsiella pneumoniae and a liver abscess. Thus, we made a diagnosis of K. pneumoniae liver abscess syndrome (KLAS). Following appropriate antibiotic treatment, the patient recovered completely without any neurological deficits. This is a novel report on K. pneumoniae cerebritis in a patient with KLAS presenting with symptoms resembling a hyperacute MCA stroke. Clinicians should consider K. pneumoniae cerebritis as a tentative diagnosis upon observing liver abscess in patients with uncontrolled diabetes and hyperacute neurological deficits.

Keyword

stroke; Klebsiella pneumoniae; liver abscess
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