Pathogenesis and Laboratory Identification of Emerging Hepatovirulent Klebsiella pneumoniae

Over the past 2 decades, a trend toward an increase in primary liver abscesses caused by Klebsiella pneumoniae has been documented. Originally thought to be more of a curiosity than a major clinical concern and to be geographically restricted to Southeast Asia, these strains have subsequently been reported from many industrialized nations and are most often linked to disease states in immunocompromised persons. Laboratory detection of such strains relies on assessing non-conventional phenotypic traits, such as hypermucoviscocity, and associated molecular genotypes. The pathogenesis of disease caused by hepatovirulent K. pneumoniae is poorly understood at present and is evolving. Clinicians and laboratorians alike need to be aware of the emergence of this traditional enteric pathogen in a new disease setting.