Laboratory investigations showed elevated CRP=186 mg/L (1.20), WBC=15 x 10⁹/L (4.00-11.00), LDH=449 U/L (125-220), and alkaline phosphatase=450 U/L (40-150). 

Culture and sensitivity of the aspirated pus from the hepatic abscess showed heavy growth of Klebsiella pneumoniae, which was resistant to ampicillin and sensitive to cefalotin,  ciprofloxacin, gentamicin, piperacillin/tazobactam, & trimethoprim/sulfa.

Gram negative mixed aerobic and anaerobic organisms (with Escherichia coli being the most frequent agent) are the most common bacterial agents responsible for the pyogenic liver abscess (PLA). Klebsiella pneumoniae, a gram-negative organism, is an emerging common cause of PLA, particularly in patients with poorly controlled diabetes mellitus and without any pre-existing liver disease. Some extrahepatic metastatic infections have been reported in patients with Klebsiella liver abscess which are endophthalmitis, meningitis/brain abscess, necrotizing fasciitis, septic pulmonary emboli/ lung abscess, splenic abscess, septic arthritis, and osteomyelitis, etc ¹.