Klebsiella pneumoniae meningitis in a 38-year-old Chinese traveller with impaired glucose tolerance: A new emerging syndrome?

et al. 2020

Preprint

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.

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

Preprint

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

et al. 2021

IDCases

Community-acquired Klebsiella pneumoniae (K. pneumoniae) central nervous system (CNS) infection combined with bacteremia is rarely identified worldwide. We received a 55-year-old woman on long-term corticosteroid therapy for Sjogren's syndrome. Onset began with acute suppurative otitis, followed by a severe headache and loss of consciousness. Cerebrospinal fluid (CSF) testing and brain imaging examinations were compatible with K. pneumoniae meningitis and likely brain abscesses, respectively. K. pneumoniae bacteremia was also found on blood cultures. Despite aggressive antibiotic and supportive therapy, the patient died after 2 day’s therapy. Corticosteroid therapy may be a risk factor for a community-acquired K. pneumoniae infection. Appropriate antibiotics and abscess drainage are still recommended, despite the poor prognosis.

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

et al. 2021

BMC Infect Dis

Background Klebsiella pneumoniae (K. pneumoniae) invasive liver abscess syndrome (ILAS) with purulent meningitis was rarely identified the mainland of China. Last winter, we received 3 cases of K. pneumoniae meningitis and all of them died in a short time. We report these cases in order to find the reason of high mortality and discuss effective effort to improve these patients’ prognosis. Case presentation Three patients with uncontrolled diabetes developed live abscess and purulent meningitis. Upon admission, the clinical manifestations, laboratory result of blood and cerebrospinal fluid (CSF) and imaging examinations were compatible with K. pneumoniae ILAS which had metastasis infection of meningitis. Even with timely adequate antibiotic therapy and strict glycemic control, all of the patients’ condition deteriorated rapidly and died in a short time. Conclusion The reason of patients’ poor prognosis might be the absence of liver abscess drainage, high level of CSF protein which indicates severe inflammation and unknown special but stronger virulence factors of K. pneumoniae the patients’ living place Zhangjiakou. Strict glycemic control, early drainage of liver abscess and appropriate antibiotic application are recommended for treating this condition, further progress on the pathogenesis and treatment of K. pneumoniae meningitis may help patients gain a better prognosis.