Klebsiella pneumoniae Invasive Syndrome

Abstract

Klebsiella pneumoniae invasive syndrome (KPIS) is a rare clinical condition characterized by primary liver abscess associated with metastatic infection. Most case reports are from Southeast Asia, with only one case described in Portugal. The Authors present the case of a 44-year-old man with a history of fever, dry cough and cervicalgia. A thoracic computed tomography (CT) scan showed multiple pulmonary and hepatic nodules, suggestive of metastatic malignancy. Both blood cultures and bronchoalveolar lavage were positive for Klebsiella pneumoniae. Imaging studies were repeated during his hospital stay, showing a reduction in both number and volume of identified lesions, thus revealing their infectious nature. This case illustrates how much this entity can mimic other illnesses.LEARNING POINTSKlebsiella pneumoniae invasive syndrome is emerging as a global disease.The imaging-led diagnosis of neoplasia was proved incorrect and could have been deleterious for the patient.The lack of diagnostic suspicion can lead to shorter antibiotic treatment regimens, therefore compromising the patient’s full recovery.

Klebsiella pneumoniae invasion syndrome: a case of liver abscess combined with lung abscess, endophthalmitis, and brain abscess

“…Kp is commonly cultured from community-acquired infections and exists as multiple serological types: capsule (K antigen type, mainly K 1 and K 2 ), mucoviscosity-associated gene A (magA, viscosity-related genes), regulator of mucoid phenotype A gene (rmpA) and aerobactin serotypes. 5 , 6 The K 1 and K 2 capsule serotypes and rmpA contribute to hypermucoviscosity, 6 – 8 which is a known virulence factor for Kp and is confirmed using a string test, in which positivity is defined as the formation of >5-mm-long viscous strings when colonies on an agar plate are stretched ( Figure 6 ). Previous studies have shown that the accuracy of the identification of highly virulent Klebsiella pneumoniae (hvKP) using the positive string test is as high as 90%, 9 while others have shown that the accuracy of identification of highly virulent gram-negative bacilli in the lung using the string test is 50%.…”

Invasive Klebsiella pneumoniae Syndrome in Qatar: A Case Report

“…Several virulence factors contribute to the pathogenicity, including hypermucoviscous-specific capsular antigens (i.e., K1 and K2 serotypes) and virulence genes FimH (fimbrial adhesion), rmpA (regulator of mucoid phenotype), uge (uridine-diphosphate galacturonate 4-epimerase), kfu (an iron uptake system), and alls (allantoin metabolism). The K1 and K2 hypermucoviscous-specific capsular serotypes are associated with invasive infections and usually have poor prognoses [7][8][9][10].…”

“Invasive Klebsiella Pneumoniae Syndrome in Qatar”

“…K1/K2 Hypermucovisocus -specific capsular serotypes are associated with invasive infections and usually have a poor prognosis. (7)(8)(9)(10).…”