{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T07:54:53Z","timestamp":1774511693339,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Hypervirulent\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    <\/jats:styled-content>\n                    (hvKp) is an emerging cause of community\u2010acquired pyogenic liver abscess (PLA), classically described in East and Southeast Asia. We report two cases of hvKp\u2010associated PLA in Caucasian women of American origin with no history of international travel, animal exposure, or Asian food consumption. Both patients presented with fever and right upper quadrant abdominal pain and were found to have solitary hepatic abscesses on imaging. Blood and abscess cultures confirmed\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>K.\u2009pneumoniae<\/jats:italic>\n                    <\/jats:styled-content>\n                    with a positive string test (&gt;\u20095\u2009mm), K2 capsular serotype, and rmpA gene, establishing the hypermucoid phenotype. While one patient had diabetes mellitus, the other had no major underlying health condition apart from the bacterial infection reported here. Both patients were successfully treated with intravenous antimicrobial therapy, initially broad\u2010spectrum and subsequently de\u2010escalated based on susceptibility results, in combination with image\u2010guided percutaneous drainage. Neither patient developed metastatic complications. These cases suggest a broader geographic and demographic distribution of hvKp\u2010associated PLA than previously recognized. The string test served as an early diagnostic clue, facilitating timely intervention. Given the potential for rapid clinical progression, early recognition and aggressive management, including antimicrobial therapy and source control, remain essential to reducing morbidity associated with hvKp PLA.\n                  <\/jats:p>","DOI":"10.1002\/ccr3.72282","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T09:13:51Z","timestamp":1773911631000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Case Series of Hypermucoid\n                    <scp>\n                      <i>Klebsiella pneumoniae<\/i>\n                    <\/scp>\n                    Liver Abscess in Caucasian Americans Without Travel History: An Epidemiologic Shift?"],"prefix":"10.1002","volume":"14","author":[{"given":"Krishna Sai Kiran","family":"Sakalabaktula","sequence":"first","affiliation":[{"name":"Rangaraya Medical College  Kakinada India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameer Kumar","family":"Majety","sequence":"additional","affiliation":[{"name":"School of Medicine Xiamen University  Xiamen People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sri Ratna Divya","family":"Nanduri","sequence":"additional","affiliation":[{"name":"Dignity Health  Stockton California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6857-4475","authenticated-orcid":false,"given":"Divya","family":"Durga","sequence":"additional","affiliation":[{"name":"NRI Medical College  Guntur India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Kreps","sequence":"additional","affiliation":[{"name":"Stony Brook Southampton Hospital  Southampton New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Devi Prasad","family":"Botu","sequence":"additional","affiliation":[{"name":"Overlook Medical Center  Summit New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7158-2856","authenticated-orcid":false,"given":"Gopichand","family":"Muppana","sequence":"additional","affiliation":[{"name":"National Pirogov Memorial Medical University  Vinnytsia Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473\u20103099(12)70205\u20100"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20030857"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2022.11.007"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.micres.2023.127446"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572\u20100241.2005.40310.x"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.1696"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00776\u201018"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1086\/590932"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1986.00360220057011"},{"issue":"3","key":"e_1_2_13_11_1","first-page":"282","article-title":"A Clinical Study of Klebsiella Liver Abscess","volume":"87","author":"Chang F. Y.","year":"1988","journal-title":"Journal of the Formosan Medical Association"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid0802.010025"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010\u2010013\u20100408\u20100"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.13007"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2008.02.005"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.micres.2020.126551"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102958.1989.tb00116.x"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.46165\u20100"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1128\/iai.54.3.603\u2010608.1986"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00029330\u2010200701020\u201000012"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.21\u20100623"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix270"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.01523\u201008"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0004982"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2013.10.014"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2005.10.006"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.7.2088\u20102092.2003"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0732\u20108893(00)00157\u20107"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72282","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.72282","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72282","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T06:06:14Z","timestamp":1774505174000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.72282"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1002\/ccr3.72282"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.72282","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2025-07-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72282"}}