Invasive<i>Klebsiella pneumoniae</i>Infections, California, USA

McCabe, Robert E.; Lambert, Larry; Frazee, Brad

doi:10.3201/eid1609.100386

Cited by 57 publications

(61 citation statements)

References 8 publications

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“…However, some clinical cases have been reported recently in Western countries (7,8,11). Here, we describe 12 cases of invasive infections due to K. pneumoniae, including five rapid and fatal bacteremia cases and seven liver abscesses, observed over a 2-year period in two university hospitals in France.…”

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Emerging Severe and Fatal Infections Due to Klebsiella pneumoniae in Two University Hospitals in France

et al. 2011

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Severe infections caused by hypermucoviscous Klebsiella pneumoniae have been reported in Southeast Asian countries over the past several decades. This report shows their emergence in France, with 12 cases observed during a 2-year period in two university hospitals. Two clones (sequence type 86 [ST86] and ST380) of serotype K2 caused five rapidly fatal bacteremia cases, three of which were associated with pneumonia, whereas seven liver abscess cases were caused by K1 strains of ST23.

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Emerging Severe and Fatal Infections Due to Klebsiella pneumoniae in Two University Hospitals in France

et al. 2011

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“…Laboratory-confirmed invasive K. pneumoniae liver abscess syndrome has been described in North America, primarily in patients of Asian descent (14-18), but only occasional reports have described molecular strain typing to confirm the K1 strain as the causative agent (19). Recently, a Caucasian man from San Diego, CA, was found to have laboratory-confirmed K1-associated recurrent liver abscesses without endophthalmitis (20).…”

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Klebsiella pneumoniae K1 Liver Abscess and Septic Endophthalmitis in a U.S. Resident

et al. 2013

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Klebsiella pneumoniae K1 is a major agent of hepatic abscess with metastatic disease in East Asia, with sporadic reports originating elsewhere. We report a case of abscess complicated by septic endophthalmitis caused by a wzyAKpK1-positive Klebsiella strain in a U.S. resident, raising concern for global emergence. CASE REPORTA 58-year-old female resident of Bronx, New York, who was originally from the Dominican Republic presented with a chief complaint of 1 day of decreased vision in her right eye and concomitant symptoms, including weakness, myalgia, low-grade fever, and right upper quadrant pain for 1 week. She had a history of uncomplicated choledochal cyst resection and Roux-en-Y hepaticojejunostomy approximately 5 years prior to presentation but no history of ocular disease or prior intraocular surgery. She reported subsequent travel to the Dominican Republic but denied travel to Asia at any point before or after her surgery. On the initial ophthalmic examination, visual acuity was 20/60 in the affected eye. Slit-lamp examination revealed moderate conjunctival injection in the right eye, along with 4ϩ cells and hypopyon in the anterior chamber. The fundus view was hazy because of opacity in the anterior segment, but the retina was flat. She was diagnosed with presumed endogenous endophthalmitis. Her vision in the affected eye worsened over the next 24 h. Because of right upper quadrant tenderness on examination, further imaging was performed, revealing a hepatic abscess (7 by 7 by 7 cm) (Fig. 1). The patient reported no history of diabetes, and the serum glucose was normal. She was treated with intravenous levofloxacin, and the abscess was drained percutaneously. Cultures of liver aspirate, blood, and urine grew K. pneumoniae susceptible to expandedand broad-spectrum cephalosporins, ampicillin-sulbactam, levofloxacin, aminoglycosides, and trimethoprim-sulfamethoxazole. The isolate exhibited a hypermucoviscous phenotype, as exemplified by a positive string test (Fig. 2). On the seventh hospital day, her ophthalmologic exam deteriorated; she was found to have a subretinal abscess in the peripheral temporal retina, and retinal detachment was noted (Fig. 3). A sample of vitreous fluid was obtained, which revealed polymorphonuclear leukocytes on Gram stain but a negative culture, and intravitreal injection of ceftazidime was performed. Over the next several weeks, the vitreous debris cleared, and the retina more clearly assumed the configuration of a bullous rhegmatogenous detachment stemming from a break related to the retinal necrosis at the site of the subretinal abscess. The patient underwent a vitrectomy for retinal detachment 2 months after her initial presentation. The patient's subsequent course was complicated by a relapse of abdominal pain and an increase in size of the liver abscess following a transition to oral therapy. An abdominal CT scan conducted 2 months after the completion of an 8-week antibiotic course demonstrated resolution of her liver abscess.Because of the similarity of this case to rep...

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“…[2][3][4] K. pneumoniae tiene 2 variantes genómicas: la clásica y la hipervirulenta . Esta tiende a producir un cuadro clínico inicial de absceso hepático de origen comunitario, afectación de pacientes sin antecedentes de enfermedad hepatobiliar, propensión a enviar metástasis a sitios distantes en 11-80 % (bacteriemia) y las [5][6][7] personas afectadas a menudo son portadores de diabetes mellitus .…”

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Absceso hepático a Klebsiella pneumoniae

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et al. 2015

Rev. Virtual Soc. Parag. Med. Int

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ResumenSe presenta caso de varón, diabético, con fiebre prolongada, ictericia y hepatoesplenomegalia. Por ecografía se constata absceso hepático y esplénico. Fue tratado exitosamente con antibiótico y drenaje percutáneo del absceso hepático. Se aisló Klebsiella pneumoniae en sangre y líquido drenado del hígado. Palabras claves: absceso hepático, absceso esplénico, Klebsiella pneumoniae, diabetes mellitus AbstractThis is the case of a diabetic man with prolonged fever, ictericia and hepatosplenomegaly. Ultrasonography confirms hepatic and splenic abscesses. Patient was successfully treated with antibiotics and percutaneous drainage of the hepatic abcess. Klebsiella pneumoniae was isolated from blood and liquid drained from liver. Keywords: hepatic abscess, splenic abscess, Klebsiella pneumoniae, diabetes mellitus Caso clínico: paciente de sexo masculino de 56 años, procedente de Itá, comerciante, consulta por sensación febril de 15 días de evolución, no graduada, de predominio vespertino, que cede parcialmente con la autoadministración de antipiréticos. Una semana antes del ingreso presenta coloración amarillenta de piel, disnea al esfuezo, progresiva, llegando a disnea en reposo, sensación de pesadez en epigastrio, astenia y anorexia. Niega vómitos, coluria, acolia, tos con expectoración.Antecedentes patológicos: conocido diabético en tratamiento con antidiabéticos orales. No conocido hipertenso. Niega ser tabaquista y etilista.Ingresa con presión arterial 120/80 mm Hg, pulso 100/min, respiración 24/min, temperatura axilar 38ºC, peso 2 70 kg, altura 1,7 m, IMC 25 kg/m . Al examen físico se observa tinte ictérico de la piel y mucosas. Lengua saburral, seca, dientes en buen estado de conservación. Pulmones: campo medio e inferior del hemitórax derecho con vibraciones vocales aumentadas, sonoridad disminuida, se auscultan crepitantes, además de sibilancias difusas bilaterales. Pulsos periféricos: disminuidos en miembros inferiores desde la región poplítea. Corazón: taquicardia, ritmo regular, no se auscultan soplos ni galope. Abdomen: globuloso sin cicatriz quirúrgica, la piel ictérica, doloroso a la palpación profunda en hemiabdomen superior, borde hepático a 10 cm del reborde costal derecho, se palpa punta de bazo, ruidos hidroaéreos presentes. Puño percusión negativa bilateral. Tacto rectal normal. No se palpan ganglios. Piel con tinte ictérico y turgencia disminuida. Sistema nervioso: lúcido, vigil, sin alteración de los pares craneales, sin déficit motor en miembros, con hiporreflexia e hipoestesia en calcetín bilateral, no signos meníngeos.Ingresa con los siguientes diagnósticos: fiebre prolongada, síndrome ictérico, síndrome de condensación pulmonar derecha, hepatoesplenomegalia, deshidratación leve, insuficiencia arterial periférica, neuropatía diabética, diabetes mellitus tipo 2 complicada.La radiografía de tórax muestra infiltrado reticular en campo inferior del pulmón derecho (fig 1). Paciente es sometido a hemocultivos y urocultivo, iniciándose luego tratamiento con ceftriaxona y levofloxacina, cubriend...

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InvasiveKlebsiella pneumoniaeInfections, California, USA

Cited by 57 publications

References 8 publications

Emerging Severe and Fatal Infections Due to Klebsiella pneumoniae in Two University Hospitals in France

Emerging Severe and Fatal Infections Due to Klebsiella pneumoniae in Two University Hospitals in France

Klebsiella pneumoniae K1 Liver Abscess and Septic Endophthalmitis in a U.S. Resident

Absceso hepático a Klebsiella pneumoniae

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