Biliary tract infection, abdominal abscess, and postoperative bleeding caused by highly virulent Klebsiella pneumoniae : a case report

Hypervirulent Klebsiella pneumoniae (hvKp) can cause invasive biliary infection with rapid progression and frequent complications. We report a 70-year-old man with type 2 diabetes and chronic renal insufficiency presenting with abdominal pain. Imaging revealed choledocholithiasis, cholecystitis, and a large intra-abdominal abscess. He underwent ERCP with stone extraction and biliary drainage, followed by laparoscopic cholecystectomy and abscess drainage. Pus culture confirmed K. pneumoniae infection. Postoperative stress ulcer bleeding and coagulation dysfunction occurred, but the patient recovered well. This case highlights the importance of early imaging, timely source control, and multidisciplinary management in high-risk patients.