Community-acquired Klebsiella pneumoniae meningitis in an alcoholic patient with an infected pancreatic pseudocyst; a case report and review of literature

Abstract

We report a case of a 49-year-old male with a history of chronic alcoholism and evidence of a pancreatic pseudocyst on CT scanning. He presented with a 3-days history of fever, loss of appetite and upper abdominal pain. Blood cultures grew Klebsiella pneumoniae and he improved clinically with a seven-day course of intravenous co-amoxiclav and metronidazole. Two weeks later he was readmitted to hospital with impaired consciousness and septic shock, and died three days later in intensive care. Post mortem examination revealed bacterial meningitis and an infected pancreatic pseudocyst. Klebsiella pneumoniae was isolated from the pancreas and meninges.

Klebsiella pneumoniae-related invasive liver abscess syndrome complicated by purulent meningitis: a review of the literature and description of three cases

“…Accordingly, when patients with T2DM present with fever, headache, coma and confusion, a high degree of suspicion should be held for ILAS besides meningitis, including possible K. pneumoniae infection [ 14 ]. However, sometimes community-acquired K. pneumoniae meningitis appears independently without a liver abscess [ 13 , 15 – 17 ]. Besides T2DM, other risk factors may include alcohol-related chronic diseases, especially alcoholic cirrhosis, which is also related to ILAS [ 15 , 16 , 18 ].…”

“…However, sometimes community-acquired K. pneumoniae meningitis appears independently without a liver abscess [ 13 , 15 – 17 ]. Besides T2DM, other risk factors may include alcohol-related chronic diseases, especially alcoholic cirrhosis, which is also related to ILAS [ 15 , 16 , 18 ]. The clinical manifestation and high leukocyte, high protein, and low glucose in each patients’ CSF are often found in cases of gram-negative bacilli meningitis [ 19 ].…”

Multi-Drug-ResistantKlebsiella pneumoniaePancreatitis: A New Challenge in a Serious Surgical Infection

“…Few reported cases of K. pneumoniaeinfected pancreatitis are documented in the literature. We were prompted to perform a case review of the published literature to identify patients with K. pneumoniae-infected pancreatitis [5,[10][11][12] (Table 1).…”

Community-acquired Klebsiella pneumoniae central nervous system infection after acute suppurative otitis

“…A total of eight patients with community-acquired K. pneumoniae meningitis not associated with liver pathology have been reported in the Caribbean, as well as in Italy, Singapore, Taiwan, the United Kingdom, and the United States [ 3 , 4 , 9 , [13] , [14] , [15] ]. However, not all of them had brain abscesses or bacteremia.…”