Brain abscess due to Klebsiella pneumoniae in a liver-transplanted child

Brain abscesses are a rare, severe complication of orthotopic liver t nsplantation (OLT).They are almost exclusively due to fungi, Nocardia, orToxoplasma, and usually occur within months of surgery. Here we report the case of an adolescent who developed a brain abscess due to Klebsiella pneumoniae 11.5 years after OLT. Fever was absent and laboratory parameters were not indicative of infectious disease, and therefore the diagnosis of a central nervous system neoplasm was considered. Subsequent magnetic resonance imaging and spectroscopy led to a diagnosis of a brain abscess, and to prompt appropriate antibiotic treatment.This case shows that K. pneumoniae may cause a brain abscess long after liver transplantation.The appearance of neurological symptoms should alert clinicians to consider a brain abscess even in the absence of overt clinical/laboratory signs of in£ammation, which may be blunted by chronic immunosuppression.