We described an elderly female with type 2 diabetes referred to our hospital with fever, nausea and upper abdominal pain. The patient had got duodenal tumor and received the pancreaticoduodenectomy（PD）12 years ago. The laboratory examinations revealed white blood cells（WBC）increasing and severe hypocalcemia. Abdominal computed tomography（CT）revealed a huge gas-forming pyogenic liver abscess（PLA）in left lobe of the liver. The patient got cured after correction of calcium metabolism disorders, treatment with antibiotic and receiving percutaneous tube drainage. We concluded that we should remain on high alert of those patients with DM and the history of cancer, when he or she gets fever of unknown origin and abdominal tenderness. PLA should be considered.
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Liver abscesses include pyogenic, amebic and fungal liver abscesses. Pyogenic liver abscesses（PLA）is one of the com-mon abscesses. The pyogenic bacteria cause PLA via retrograd-ing through the biliary tract, spreading through the hepatic ar-tery or the portal vein or direct infection after the liver injury. Diabetes and cancer are the risks of PLA. We report here a case of huge pyogenic liver abscesses due to Klebsiella pneumoniae in an elderly diabetic patient who was subjected to the pancreat-icoduodenectomy（PD）, and discuss clinical course, treatment and possible reasons for association between PLA and diabetes.
