Community-acquired Klebsiella pneumoniae central nervous infection with acute suppurative otitis and bacteremia: a case report in mainland China

Abstract

Community-acquiredKlebsiella pneumoniae (K. pneumoniae) central nervous system (CNS) infection combined with bacteremia was rarely identified world. We received a 55-year-old womanwho was under hormone therapy because of Sjogren's syndrome.The onset of this case was acute suppurative otitis,then she developed headache and unconscious, the cerebrospinal fluid (CSF) and imaging examinations were compatible with K. pneumoniae meningitis and suspicious brain abscesses, and K. pneumoniae bacteremia was also combined. Even with adequate antibiotic and supportive therapy, the patient’ relatives refused further assessment of intracranial lesions and took the patient back home, finally the patient died of no spontaneous breathing.Hormone therapy might be the risk factor of community-acquiredK. pneumoniaeinfection. Appropriate antibiotic application and infection focus drainage should be tried for treating this condition. The reason of patient’s death might be the CNS infection combined with K. pneumoniaebacteremia and the absence of intracranial lesion elimination. This case is reported in order to help us know this rare disease and promote a further progress on its pathogenesis and treatment.