A 71-year-old male with past medical history of liver cirrhosis presented with a 5-day history of general malaise, dysuria and lower abdomen fullness. The patient presented with irritative symptoms such as frequency and nocturia. Obstructive symptoms such as poor urine stream, terminal dribbling and incomplete voiding. He denied nausea, bowel habit change, body weight loss and fever. He had past liver abscess history with complete resolution 3 years previously. His family history and operation history were unremarkable. On examination, vital signs were stable, and abdominal examination showed unremarkable finding and digital rectal examination showed an extremely tender boggy prostate. Investigations showed, white blood cell (WBC) count of 33,000/μL with band form 15 %, neutrophil 81 %, hemoglobin of 13.9 g/dL, platelet of 51,000/μL, C-reactive protein of 9.62 %, blood urea nitrogen of 86 mg/dL, creatinin of 2.1 mg/dL, total bilirubin of 2.48 mg/dL, direct bilirubin of 0.88 mg/dL, albumin of 2.4 g/dL, AST of 79 U/L, ALT of 64 U/L, alkaline phosphatase of 231 U/L; with PSA total:15.786 ng/mL (0–4), PSA free: 0.255 ng/mL (<0.934), and alpha-feto protein: 1.02 ng/mL (1.09–8.04). HIV and serology for hepatitis B and C were negative. Urine analysis revealed pyuria with urine white blood cells of too numerous to count; blood cultures and urine culture showed growth of K. pneumoniae. Chest radiography and KUB revealed unremarkable findings. Abdominal computed tomography demonstrate multiple lobulated liver abscess with a large measurement of about 3.2 × 4 cm without air fluid level. The abscess involved segment IV, segment V, segment VI, segment VII, and segment VIII. The urinary bladder was thickened secondary to urinary tract infection. The prostate and seminal vesicle was enlarged and hypodense, having fluid density compatible with prostate abscess formation with the right one measuring about 4.3 × 2.4 cm and left one measured about 4.3 × 3.3 cm and seminal vesicle abscess measured about 3.8 × 3.1 cm. Calcification within the urethral wall was noted. No evidence of endophthalmitis could be discerned. The patient was initially started with cefazolin treatment but progressive low back pain, hydrocele and debilitation developed. Repeat contrast enhanced abdominal CT demonstrated progressive liver abscess, prostate abscess and emerging psoas muscle abscess. MRI of pelvis demonstrated osteomyelitis over right pubic symphysis. Antibiotic was shifted to ceftriaxone 2.0 g iv QD for better penetration, and the patient’s clinical condition gradually improved after 6 weeks of empiric antibiotic treatment. The final capsular serotype of K. pneumoniae was K1 and genotyping revealed rmpA1, rmpA2 (+) and aerobactin (+).