{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T05:55:24Z","timestamp":1767851724523,"version":"3.49.0"},"reference-count":12,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,8,12]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:p>Hypervirulent strains of <jats:italic>Klebsiella pneumoniae<\/jats:italic> are known to cause liver abscesses and other metastatic infections. Being Asian and having diabetes are known host risk factors. Here we present an unusual case of a Filipino ballet dancer\u2013choreographer with diabetes presenting with bilateral leg pains initially thought to be cellulitis, but was eventually diagnosed as bilateral subcutaneous leg abscesses. He also had a liver abscess, thankfully asymptomatic, which was only discovered on imaging. The occurrence of three distant abscesses in one patient, hence \u20183-in-1,\u2019 makes this case worth reporting. Bilateral subcutaneous leg abscesses as the presenting manifestation of this infection have not been reported yet. We hypothesise that his occupation which makes use of frequent contractions of leg muscles led to increased blood flow and preferentially directed blood-borne bacteria to localise in both legs. We have also characterised the pathogen with regards to its hypermucoviscous phenotype, capsular type, virulence genes and phylogeny.<\/jats:p>","DOI":"10.1136\/bcr-2020-235926","type":"journal-article","created":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T03:20:34Z","timestamp":1599535234000},"page":"e235926","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["3-in-1: bilateral subcutaneous leg abscesses and liver abscess from <i>Klebsiella pneumoniae<\/i>"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0622-8287","authenticated-orcid":false,"given":"Mark Anthony Santiago","family":"Sandoval","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines"},{"name":"Department of Physiology, College of Medicine, University of the Philippines Manila, Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2864-2879","authenticated-orcid":false,"given":"Ma Carrissa Abigail","family":"Roxas","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Sonia","family":"Salamat","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Medicine, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jarold","family":"Pauig","sequence":"additional","affiliation":[{"name":"Department of Radiology, College of Medicine and Philippine General 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