Abstract
Pyogenic liver abscess (PLA) is a rare but potentially life-threatening condition, especially in immunocompromised and diabetic patients. Complications such as sepsis and diabetic ketoacidosis (DKA) increase morbidity and mortality among diabetic patients. We report the case of a 50-year-old male patient who presented with fever, confusion, and hypotension. Initial assessment revealed septic shock and DKA. Imaging confirmed a large liver abscess. Despite intensive medical therapy, laparoscopic drainage was required. Culture revealed Klebsiella pneumoniae. The patient required prolonged ICU care, insulin therapy, targeted antibiotics, and multidisciplinary management, after which he gradually improved. Early suspicion and timely intervention are lifesaving in complicated PLA cases. In patients with diabetes and sepsis, multidisciplinary care is crucial for optimizing outcomes.