Disseminated Hypervirulent Klebsiella pneumoniae Infection Following Travel: A Case of Cavitating Pneumonia, Hepatic and Renal Abscesses, and Thrombosis

Hypervirulent <i>Klebsiella pneumoniae</i> (hvKP) is a recently emerging pathogen that causes severe community-acquired infections in immunocompetent patients, in contrast to classical <i>K. pneumoniae,</i> which is found in nosocomial settings. We report the case of a healthy 55-year-old woman who, following recent travel to Singapore, presented with diabetic ketoacidosis (DKA) and septic shock. She presented with fever, cough, myalgias, and confusion, imaging demonstrating bilateral cavitating pneumonia, hepatic and perinephric abscesses, and renal vein and inferior vena cava thrombosis. Whole-genome sequencing identified hvKP (ST420, K2 capsular type, rmpA, rmpA2). The patient required admission to the intensive care unit (ICU) for mechanical ventilation, broad-spectrum antibiotics, and anticoagulation, and, despite progress on a stepwise incline, irreversible cavitating lung necrosis necessitated prolonged ICU dependence (>35 days). This case is notable for hvKP's virulence, its relation to travel to endemic regions, and the impact of diabetes on susceptibility, underscoring the need for early diagnosis, targeted therapy, and scrupulous source control.