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December 8, 1978

Hepatic Abscess and Osteomyelitis From Klebsiella pneumoniae

Author Affiliations

From the Departments of Medicine of the New Jersey Medical School, and the Newark Beth Israel Medical Center, Newark, NJ. Dr Goldman is now with the National Institutes of Health, Bethesda, Md.

JAMA. 1978;240(24):2660. doi:10.1001/jama.1978.03290240060029

KLEBSIELLA pneumoniae is an unusual cause of hepatic abscess and a rare cause of acute hematogenous osteomyelitis of long bones. We describe a case of hepatic abscess and acute osteomyelitis of both tibias seeded from a urinary tract infection in an otherwise healthy man.

Report of a Case  A 48-year-old black man was hospitalized with a ten-day history of fever, chills, malaise, anorexia, and weight loss. Four days before admission, a constant, sharp, right upper quadrant pain developed. There were episodes of frequency, nocturia, and urgency with incontinence during the previous six months but no such complaints on admission. There was no history of genitourinary (GU) instrumentation or urinary tract infection.Admission vital signs included temperature, 39.5 °C; pulse rate, 100 beats per minute; respirations, 18/min; and blood pressure, 140/90 mm Hg. The patient was diaphoretic, with right upper quadrant pain aggravated by inspiration. There was no scleral icterus. The