Isolation ofKlebsiella ozaenaeandKlebsiella rhinoscleromatisin a General Hospital

Berger, Stephen A.; Pollock, Alan A.; Richmond, Alma S.

doi:10.1093/ajcp/67.5.499

Cited by 25 publications

(25 citation statements)

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“…Whether blood culture is a prognostic index in K. ozaenae meningitis is unknown. Among the four patients reported in the two previous studies with K. ozaenae septicemia [3,4], three died. Of the four patients in this study with K. ozaenae meningitis, two had positive blood cultures; one recovered and one died.…”

Section: Discussionmentioning

confidence: 91%

“…K. ozaenae causes a characteristic infection of the nose and upper nasal passages, ozena [2]. Recently, the pathogen has been found to have pathogenicity in otitis media, mastoiditis, urinary tract infection, soft tissue infection and bacteremia [3,4]. In reviewing the English-language literature on K. ozaenae meningitis, only two cases [5,8] have been described (Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

“…It has been implicated in a chronic inflammatory disease of the upper respiratory tract -ozena, a progressive fetid atrophy of the nasal mucosa [2]. In 1977, K. ozaenae was isolated from blood, wound abscess, sputum or external auditory meatus of patients who had no clinical features of ozena [3]. It was recognized as a cause of infection of the urinary tract, soft tissue, middle ear and blood [4].…”

Section: Introductionmentioning

confidence: 99%

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Klebsiella ozaenae meningitis: Report of two cases and review of the literature

Tang

Chen

1994

Infection

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Meningitis is rarely caused by Klebsiella ozaenae, a colonizer of the oral and nasopharyngeal mucosa. We describe two patients with K. ozaenae meningitis. Both patients suffered from a primary disease of the nasopharyngeal pathway; one had nasopharyngeal carcinoma and the other ozena. Review of the English-language literature from 1966 to the present revealed only two cases of K. ozaenae meningitis; pneumonia and hyperglycemia were noted in one patient and otitis media, sinusitis and diabetes mellitus in the other. All these four patients were over 50 years old. Of the four patients, two treated with third-generation cephalosporins recovered whereas one of the two treated with chloramphenicol died. One patient who died had a positive blood culture for K. ozaenae. Blood culture was positive in only one of the three survivors. Whether chloramphenicol should be replaced by a third-generation cephalosporin and whether blood culture indicates a poor prognosis in K. ozaenae meningitis remain to be determined.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Klebsiella ozaenae meningitis: Report of two cases and review of the literature

Tang

Chen

1994

Infection

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“…This bacterium is the cause of atrophic rhinitis or ozena [14], but this organism has usually been considered an opportunistic invader. However, Klebsiella ozaenae may cause bacteremia [15] or invasive infections [16], mostly in patients with various degrees of immunosuppression. This patient had no clinical evidence of ozena.…”

Section: Discussionmentioning

confidence: 99%

Pituitary abscess: a report of two cases

et al. 2007

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Pituitary abscess (PA) is an infrequent disease, which consists of an infection within the sella turcica that might be life-threatening. We present here two cases of this rare entity. Case 1: A 53-year-old woman was followed for an incidentally found pituitary cyst. Six years later the cyst enlarged and transsphenoidal surgery was performed. Two years later, the patient developed sudden onset of intense headache and nausea. The MRI showed a 2 by 2.5 cm sellar and suprasellar mass, that enhanced peripherally with gadolinium contrast and became hyperintense in T2-weighted images, suggesting a new-onset cystic lesion. During transsphenoidal surgery, large amounts of purulent material were drained from the sella. The cultures were positive for Klebsiella Ozaenae. Case 2: A 63-year-old woman, 4 years after transsphenoidal resection of a GH-secreting macroadenoma, developed a new sellar 2.6 cm cystic mass. On re-operation, purulent material was drained from the sella. The lesion persisted on the MRI and visual acuity worsened so a repeat pituitary decompression was carried out 6 months later, obtaining the same pathological results. Three years later, the MRI still shows the same mass. She feels well and her physical examination and clinical history are unremarkable. These cases illustrate the difficulties in the diagnosis and management of this rare entity.

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“…K. pneumoniae subsp. ozaenae has also been isolated from acute infections, such as the wounds of patients with underlying diseases (3,7). The pathogenicity of K. pneumoniae subsp.…”

Section: Case Reportmentioning

confidence: 99%

Laryngeal Scleroma Associated with Klebsiella pneumoniae subsp. ozaenae

Champs

Vellin²,

Diancourt

et al. 2005

J Clin Microbiol

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Klebsiella pneumoniae subsp. ozaenae was isolated from the pharynx of a woman with laryngeal scleroma. K. pneumoniae subsp. ozaenae is rarely isolated from clinical infections and has never been reported in laryngeal scleroma, which is usually caused by K. pneumoniae subsp. rhinoscleromatis. CASE REPORTIn 1999, a 33-year-old woman who was a native of Algeria was admitted to the otolaryngology ward for a 3-year evolutive chronic dysphonia. Her history showed that she had had idiopathic thrombopenic purpura and chronic maxillary sinusitis. Fibroscopic laryngeal examination revealed an irregularity of the right vocal cord. The larynx was mobile, and there was a purulent posterior discharge descending from her inflammatory nasal fossae. Computed tomography showed a mucosal hyperplasia of the maxillary sinus. Endoscopy of the upper respiratory tract under general anesthesia showed an indurate whitish lesion located at the front third of the right vocal cord, the anterior commissure, and the front subglottis and a second similar lesion at the front subglottis 1 cm below the vocal folds. Biopsy specimens were taken under a microscope. The lesions were then vaporized with a carbon dioxide laser device.Histopathologic features revealed lymphoplasmocytic inflammation of the vocal cord and a subglottic lymphoplasmocytic hyperplasia with fibrosis of the underlying cord. The patient was treated with aerosol and speech therapy.One year later, after a 3-week stay in Algeria, the patient again consulted for an increase in the dysphonia without dyspnea. Explorations were prescribed, including biologic examinations and laryngeal computed tomography. Blood samples were normal; and two lesions of calcic density were seen on the computed tomography scan, one at the right subglottis and the other at the anterior subglottal region. The diagnosis of laryngeal scleroma was evoked. A microlaryngoscopic exploration was performed and showed a glottal and a subglottal cartilaginous-like lesions. The second histopathological examination showed an inflammatory reorganization, including plasmocytes and giant histiocytes with piles of bacteria at the glottic level, tracheal parakeratosis, and bony metaplasia.

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Isolation ofKlebsiella ozaenaeandKlebsiella rhinoscleromatisin a General Hospital

Cited by 25 publications

References 0 publications

Klebsiella ozaenae meningitis: Report of two cases and review of the literature

Klebsiella ozaenae meningitis: Report of two cases and review of the literature

Pituitary abscess: a report of two cases

Laryngeal Scleroma Associated with Klebsiella pneumoniae subsp. ozaenae

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