近年来，高毒力肺炎克雷伯菌（hvKp）引起了越来越多的关注。它通常会引起肝脓肿，并通过血液传播到其他部位，如眼睛、大脑、肺部。 5.5% 的阵发性交感神经过度活跃综合征与感染、脑积水、脑肿瘤和一些未知原因有关。患有脑实质局灶性病变的年轻患者发生阵发性交感神经亢进 (PSH) 的风险较高。本病例报告详细介绍了健康个体中诊断出的肺炎克雷伯菌的临床特征。除了肝脓肿、菌血症和高血糖之外，还有脑脓肿、疝气和术后阵发性交感神经亢进，这是疾病或症状之间意想不到的关联。经过综合治疗，包括早期引流脓肿、快速病原诊断、及时适量抗生素治疗，患者病情稳定。两个月随访，未见感染复发迹象，神经功能恢复，可参加正常体力活动。肺炎克雷伯菌感染症状通常逐渐出现，误诊率较高。当年轻患者突然出现高烧并在特定部位出现脓肿时，应常规考虑肺炎克雷伯菌感染。感染引起的阵发性交感神经亢进综合征很少见，但出现临床特征时应进行临床评分（PSH评估措施，PSH-AM评分）。早期诊断和治疗可改善预后。Copyright (c) 2024 刘雪芳，余宁，路淮海，赵银龙，朱俊宇，刘亚。

In recent years, hypervirulent Klebsiella pneumoniae (hvKp) has attracted increasing attention. It usually causes liver abscesses, which spread through the bloodstream to other parts such as the eyes, brain, lungs. 5.5% of all paroxysmal sympathetic hyperactivity syndrome are associated with infection, hydrocephalus, brain tumors, and some unknown causes. Younger patients with focal lesions of the brain parenchyma are at higher risk of paroxysmal sympathetic hyperactivity (PSH).This case report details the clinical features of Klebsiella pneumoniae diagnosed in a healthy individual. In addition to liver abscesses, bacteremia, and hyperglycemia, there are also brain abscesses, hernias, and postoperative paroxysmal sympathetic hyperactivity, an unexpected association between diseases or symptoms. The patient stabilized after comprehensive treatment, including early drainage of abscesses, rapid pathogen diagnosis, and timely and appropriate antibiotics. At a two-month follow-up, no signs of infection recurrence were noted, and the patient regained neurological function and could participate in regular physical activity.Symptoms of Klebsiella pneumoniae infection usually appear gradually, and misdiagnosis is common. When young patients suddenly develop high fever and abscess at a particular site, Klebsiella pneumoniae infection should be considered routine. Paroxysmal sympathetic hyperactivity syndrome caused by infection is rare, but a clinical score (PSH assessment measure, PSH-AM score) should be performed when clinical features appear. Early diagnosis and treatment can improve the prognosis.Copyright (c) 2024 Xuefang Liu, Ning Yu, Huaihai Lu, Yinlong Zhao, Junyu Zhu, Ya Liu.