<p>Multi-Organ Abscesses and 5th Cervical Vertebra Bone Destruction Related with <em>Klebsiella ozaenae</em> Infection: A Case Report</p>

Abstract

Klebsiella ozaenae (K. ozaenae) is a causative pathogen of some rare diseases such as primary atrophic rhinitis and ozena. Here, we describe one case of a potentially lethal kind of K. ozaenae infection in which multiple organs were implicated. A 40-year-old diabetic male patient presented to our hospital due to fever with right anterior chest mass and neck and shoulder pain for half a month. Based on all examination results, he was diagnosed with sepsis, bilateral pulmonary/right chest wall/liver abscesses and 5th cervical vertebra bone destruction with prevertebral abscesses, all related with K. ozaenae infection. During the first time of admission, he was treated with antimicrobials without operations. Twelve days after his first discharge, fever and pain occurred again, the patient was treated with antimicrobials, operations (anterior debridement, spinal canal decompression, iliac bone graft fusion and internal fixation) and rehabilitation at second admission. The patient recovered well and was discharged from hospital. This case report demonstrates that K. ozaenae can trigger a wide range invasive infections. Particularly, 5th cervical vertebra bone destruction was first reported as a clinical manifestation of K. ozaenae infection in our patient.

Epidemiological characteristics of Klebsiella ozaenae infection and its antibiotic susceptibility: Experience of a tertiary care hospital in the Eastern Province of Saudi Arabia

“…ozaenae from abscesses such as subphrenic abscess, pituitary, splenic, and multiorgan abscesses. [ 5 9 22 23 ]…”

A Case of Complicated Pneumonia Caused by Klebsiella ozaenae

“…K. ozaenae is the causative agent of non-fatal diseases, such as chronic rhinitis and rhinoscleroma [4]. Although infections caused by K. ozaenae are rare, life-threatening infections have been reported [5], and K. ozaenae can cause fatal diseases, such as sepsis, meningitis, and cerebral abscess [5][6][7][8][9]. Reported risk factors for K. ozaenae bacteremia include immunosuppression and diabetes mellitus [5].…”

“…However, K. ozaenae is the causative pathogen of some rare diseases, including primary atrophic rhinitis [4]. Although K. ozaenae is a rare human pathogen that seldom causes serious infection [5,6], it can cause fatal diseases, such as sepsis, meningitis, and cerebral abscess [5][6][7][8][9]. Risk factors for K. ozaenae bacteremia include chronic rhinitis, old age, prior antibiotic usage, immunosuppression, malignancy, alcohol abuse, and diabetes mellitus [5].…”

A Rare Case of Escherichia coli Chest Wall Abscess With Rib Osteomyelitis in a Patient With Crohn’s Disease

“…Chest wall abscess is a rare entity that can occur as a primary phenomenon due to hematogenous spread of infections from a different site or secondary to blunt chest wall trauma, thoracic wall surgery, direct extension from lung, or pleural infection [ 1 , 2 ]. Nontuberculous pathogens causing abscesses of chest wall include Actinomyces, Salmonella, Staphylococcus aureus, Acinetobacter, Streptococcus, Prevotella bivia, Peptostreptococcus, Fusobacterium necrophorum, Burkholderia cenocepacia, Bartonella henselae, Nocardia, Entamoeba histolytica, Klebsiella ozaenae, Mycobacterium avium intracellulare , and very rarely, E. coli [ 1 , 3 ]. To our knowledge, primary chest wall abscess due to E. coli has been reported in only three published cases thus far, in association with concurrent E. coli urinary tract infection [ 1 , 4 , 5 ]; however, only one case had evidence of bacteremia [ 1 ].…”