Isolated pyogenic pancreatic abscess mimicking a neoplasm.

CONTEXT: Pancreatic abscesses are uncommon and usually occur in the setting of pancreatitis. Isolated pyogenic pancreatic abscesses without any precipitating events are extremely rare. CASE REPORT: A 72-year-old man with a two month history of non-specific abdominal discomfort, distension, anorexia and weight loss was admitted for further evaluation. A computer tomography scan showed a lesion of the pancreatic head suspicious for a malignancy. Unexpectedly, Klebsialla pneumoniae was isolated from the aspiration biopsy without any evidence of malignancy. A repeat CT scan four months later showed resolution of the abscess after a six week course of antibiotic.
CONCLUSION: Our case highlights a rare case of isolated pyogenic pancreatic abscess secondary to Klebsialla pneumoniae mimicking an underlying pancreatic malignancy. Infective causes should be considered to avoid any unnecessary major surgery.