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Background Liver abscess has formerly been a polymicrobial infection. Currently, liver abscess due to Klebsiella pneumoniae is increasingly reported, predominantly in Southeast Asia for unknown reasons. Liver abscess due to Klebsiella pneumonia has never been previously reported in Sri Lanka. Case presentation A 63-year-old Sinhalese man with diabetes mellitus and a poor glycemic control presented with fever, loose stools, and loss of appetite of 1 week’s duration. An examination was unremarkable apart from a mild non-tender hepatomegaly. Investigations indicated a septic process with neutrophil leukocytosis, thrombocytopenia, and raised inflammatory markers with acute kidney injury. Sonography of his abdomen revealed a large liver abscess with two blood cultures positive for Klebsiella pneumoniae. He made a complete recovery following aspiration of the abscess and treatment with intravenously administered ceftriaxone. Conclusion Liver abscess due to Klebsiella pneumoniae is an emerging infection and most commonly reported from Southeast Asia. In Sri Lanka, further studies are necessary to understand the epidemiology and modes of spread. Furthermore, a high index of suspicion is essential as early detection is the key to successful treatment and prevention of complications.

Thyrotoxicosis can present with a wide array of clinical manifestations, among which pancytopenia is a rare entity. The disease itself, as well the treatment, can result in pancytopenia which makes the diagnosis more difficult and crucial. The mechanisms underlying are poorly understood currently. Antithyroid drugs which are well known to produce cytopenias as a side effect can safely be implemented in the management. Pancytopenia of thyrotoxicosis should completely reverse with the establishment of euthyroid state. We report a rare case of thyrotoxicosis presenting with pancytopenia which completely resolved with antithyroid treatment.