A 50-year-old man with poorly controlled diabetes was admitted to our hospital due to a high fever. Enhanced abdominal computed tomography (CT) showed a focal low-density wedged-shaped area in the right kidney and a low-density area with an enhanced wall in the left lobe of the liver. Enhanced chest CT showed scattered multiple nodules with cavitation in the lung periphery. Pulmonary perfusion scintigraphy showed perfusion defects in the same area as in chest CT. Klebsiella pneumoniae was detected from venous blood, sputum, urine and discharge from a liver abscess. We diagnosed the patient as having septic pulmonary emboli (SPE), and a pyogenic liver abscess secondary to acute focal bacterial nephritis (AFBN). Clinical symptoms, liver abscess, and multiple nodular lesions in the lung improved following treatment with insulin and antibiotics. Poorly controlled diabetes should be recognized as predispositional for AFBN, SPE, and pyogenic liver abscess.