Abstract: This article reports a case of invasive Klebsiella pneumoniae liver abscess syndrome (IKPLAS). The patient was transferred to Qingdao Public Health Clinical Center with suspected hemorrhagic fever with renal syndrome (HFRS). Diagnostic evaluations confirmed liver abscess and septic shock. Blood and pus cultures both identified Klebsiella pneumoniae (KP). The patient developed concurrent heart failure and respiratory failure but was ultimately cured through anti-infection therapy, mechanical ventilation, and multi-organ support. This case highlights that KP infection is a common cause of liver abscess and may rapidly progress to IKPLAS. Characterized by critical severity, rapid progression, and high mortality, IKPLAS necessitates early blood cultures and antimicrobial susceptibility testing to guide targeted antibiotic therapy. Notably, the initial misdiagnosis of HFRS in this case underscores the importance of differentiating sepsis from HFRS. Although these conditions share overlapping clinical and laboratory features, their distinct pathogenesis and treatment strategies demand prompt diagnostic investigations to clarify the diagnosis and guide therapy. By reviewing this case, we aim to provide clinical insights into distinguishing HFRS from sepsis, as well as optimizing the management of sepsis and IKPLAS, thereby reducing mortality and improving prognosis.