Klebsiella pnuemoniae liver abscess following screening colonoscopy: a case report

Colonoscopy is a cornerstone of colorectal cancer screening with a low incidence of complications such as bleeding and perforation. Infectious complications such as liver abscesses are exceedingly rare. We report a case of a 72-year-old Sri Lankan man with a background of diabetes mellitus and diverticulosis who developed a pyogenic liver abscess (PLA) following an uncomplicated colonoscopy performed as part of the New Zealand bowel screening programme. The abscess was caused by Klebsiella pneumoniae, a pathogen commonly associated with such infections. He was successfully treated with broad-spectrum antibiotics and ultrasound-guided drainage. This case raises the possibility of a rare association between colonoscopies and pyogenic liver abscesses, even in non-invasive procedures, particularly in high-risk patients, though direct causality cannot be established. We reviewed potential mechanisms and relevant literature in this case report.