Klebsiella pneumoniae Cerebritis Masquerading as Hyperacute Middle Cerebral Artery Syndrome

Several clinical syndromes can present with the symptoms or signs resembling an acute stroke. A 52-year-old woman with uncontrolled diabetes presented with symptoms of a hyperacute right middle cerebral artery (MCA) stroke. However, there was a discrepancy between the patient’s clinical symptoms and the multimodal neuroimaging findings. Further diagnostic workup confirmed bacteremia and cerebritis caused by Klebsiella pneumoniae and a liver abscess. Thus, we made a diagnosis of K. pneumoniae liver abscess syndrome (KLAS). Following appropriate antibiotic treatment, the patient recovered completely without any neurological deficits. This is a novel report on K. pneumoniae cerebritis in a patient with KLAS presenting with symptoms resembling a hyperacute MCA stroke. Clinicians should consider K. pneumoniae cerebritis as a tentative diagnosis upon observing liver abscess in patients with uncontrolled diabetes and hyperacute neurological deficits.