Sticky Klebsiella (Hypermucoid variant) 

Diagnosis of Hypermucoid variant Klebsiella (Hypermucoviscosity phenotype) 

String test done in lab after identifying Klebsiella pneumoniae, + test is >5 mm viscous string from the colony on an agar plate

(c) Andres Rivero et al. J. Clin. Microbiol. 2010;48:639-641

Risk factors for KLA (Klebsiella Liver Abscess)

DMII (poor neutrophil control impairs neutrophil phagocytosis of capsular subtypes)
Asian descent (especially Taiwan)
Prior antibiotic use

Clinical manifestations

Fever (93 %)
RUQ tenderness (71 %)
N/V/diarrhea
Leukocytosis

Complications (in addition to liver abscess)

Endolphalmitis (ask about ocular symptoms daily!)
Meningitis, Brain Abscess

Treatment

Drainage of liver abscess
Cephalosporins (commonly CTX), can add Flagyl if anaerobic coverage needed, plan for     4-6 weeks antibiotic course depending on resolution of abscess