Abstract
INTRODUCTION: The emergence of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) presents a formidable challenge to public health and clinical medicine. This dual phenotype of hypervirulence and multi-drug resistance often complicates treatment options, leaving patients with limited antimicrobial regimens. Consequently, adverse clinical outcomes and high mortality rates are common. Ceftazidime-avibactam (CAZ-AVI) is recognized globally as a critical option for treating infections caused by resistant gram-negative bacteria. CASE REPORT: We present a case of invasive Klebsiella pneumoniae liver abscess syndrome caused by a CR-hvKP infection. The patient exhibited a bloodstream infection, lung and liver abscesses, and suppurative meningitis, eventually developing a brain abscess. Treatment with a combination of meropenem and CAZ-AVI led to a favorable clinical outcome. CONCLUSION: This case report indicates that combining CAZ-AVI with an antimicrobial agent that is in vitro non-susceptible (carbapenems in this case) is safe and effective for treating severe, multi-site infections caused by CR-hvKP, including central nervous system infections. This case serves as a clinical reference for managing similar patients in practice.