{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T07:49:29Z","timestamp":1753861769852,"version":"3.41.2"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australas J Ultrason Med"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>This case examines the sonographic and clinical challenge of diagnosing a <jats:italic>Klebsiella pnumoniae<\/jats:italic> pyogenic liver abscess with systemic metastatic infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Description<\/jats:title><jats:p>The patient in this case study is an 81\u2010year\u2010old man who presented with intermittent rigors. Following radiological and clinical assessments, a <jats:italic>Klebsiella pnumoniae<\/jats:italic> pyogenic liver abscess, with evidence of systemic metastatic infection, was diagnosed. Sonographic features of the liver abscess were atypical for a cystic lesion and instead appeared as a solid mass, raising the possibility of malignancy. Treatment of intravenous ceftriaxone infusions resulted in full resolution of the liver lesion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The discussion criticises the terminology when describing hepatic lesions, which result from a <jats:italic>Klebsiella pnumoniae<\/jats:italic> infection. The term hepatic phlegmon is appropriate when a liver lesion caused by bacterial infection demonstrates a solid appearance on radiologic imaging. The term hepatic abscess is appropriate in cases where liver lesions caused by bacterial infection demonstrate a fluid filled core on radiologic imaging. Differentiation of these terms is important when treating the underlying lesion as a phlegmon, in contrast to an abscess, cannot be drained because it contains no pus. The variable sonographic appearances of <jats:italic>Klebsiella pnumoniae<\/jats:italic> pyogenic abscesses were also examined. Despite reported sonographic appearances in the literature, none are sufficient to distinguish a pyogenic liver abscess from malignancy without further investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ultrasound operators should be aware of the variable sonographic appearances of a <jats:italic>Klebsiella pnumoniae<\/jats:italic> liver abscess and how these features, combined with non\u2010homogenous terminology, can obfuscate the correct diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajum.12406","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T04:59:06Z","timestamp":1727758746000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Klebsiella liver phlegmon mimicking a solid liver tumour"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8240-601X","authenticated-orcid":false,"given":"Martin","family":"Necas","sequence":"first","affiliation":[{"name":"Te Whatu Ora Waikato, New Zealand  183 Pembroke Street, Waikato Hospital Hamilton 3204 New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7276-1546","authenticated-orcid":false,"given":"Jereme","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Te Whatu Ora Southern, New Zealand  201 Great King Street, Central Dunedin Dunedin 9016 New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70205-0"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.894929"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v17.i12.1622"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2423051344"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.11101876"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2016150196"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1471-6907"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004728-200603000-00004"},{"issue":"3","key":"e_1_2_11_10_1","article-title":"Klebsiella pneumoniae invasive syndrome","volume":"5","author":"Evangelista V","year":"2018","journal-title":"Eur J Case Rep Intern Med"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.2510-18"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2011.03.006"},{"issue":"1","key":"e_1_2_11_13_1","first-page":"124","article-title":"Multiple inflammatory Pseudotumors of the liver demonstrating spontaneous regression: a case report","volume":"12","author":"Ishii\u2010Kitano N","year":"2022","journal-title":"Lifestyles"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jimed.2022.04.002"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.12347"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2014.12.001"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.23231"},{"issue":"3","key":"e_1_2_11_18_1","first-page":"289","article-title":"Pyogenic liver abscess: contrast\u2010enhanced ultrasound allows morpho\u2010evolutive classification and guides personalized management","volume":"3","author":"Francica G","year":"2022","journal-title":"Exp Ther Med"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15235"}],"container-title":["Australasian Journal of Ultrasound in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajum.12406","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T17:09:46Z","timestamp":1744391386000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajum.12406"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,30]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1002\/ajum.12406"],"URL":"https:\/\/doi.org\/10.1002\/ajum.12406","archive":["Portico"],"relation":{},"ISSN":["1836-6864","2205-0140"],"issn-type":[{"type":"print","value":"1836-6864"},{"type":"electronic","value":"2205-0140"}],"subject":[],"published":{"date-parts":[[2024,9,30]]},"assertion":[{"value":"2024-09-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e12406"}}