Monomicrobial necrotizing fasciitis in a white male caused by hypermucoviscous Klebsiella pneumoniae

Gunnarsson, Gudjon Leifur; Brandt, P.; Gad, Dorte; Struve, Carsten; Justesen, Ulrik Stenz

doi:10.1099/jmm.0.011064-0

Cited by 23 publications

(16 citation statements)

References 17 publications

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“…Three cases have been described in Europe. 10 – 12 The first case of K. pneumoniae necrotizing fasciitis described in North America was in 2007, in which a Cambodian man with travel to Cambodia six months prior was diagnosed with necrotizing fasciitis and died in three days. 13 Two subsequent reports described K. pneumoniae necrotizing fasciitis in patients who had no recent travel to Asia and were not of Asian descent.…”

Section: Discussionmentioning

confidence: 99%

Necrotizing Fasciitis Caused by Hypermucoviscous Klebsiella pneumoniae in a Filipino Female in North America

Ng¹,

Frazee²

2015

WestJEM

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Necrotizing fasciitis caused by Klebsiella pneumoniae has been described in Southeast Asia, but has only recently begun to emerge in North America. The hypermucoviscous strain of K. pneumoniae is a particularly virulent strain known to cause devastatingly invasive infections, including necrotizing fasciitis. Here we present the first known case of necrotizing fasciitis caused by hypermucoviscous K. pneumoniae in North America.

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Section: Discussionmentioning

confidence: 99%

Necrotizing Fasciitis Caused by Hypermucoviscous Klebsiella pneumoniae in a Filipino Female in North America

Ng¹,

Frazee²

2015

WestJEM

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“…It also has been described outside of the Asian Pacific Rim 21 . Psoas abscess, 7 , 109 , 134 deep neck infection, 11 , 16 , 17 osteomyelitis 7 , 13 , 109 and septic arthritis 7 , 109 have all been described and may be the presenting site of infection.…”

Section: Clinical Diseasementioning

confidence: 99%

“…It is reasonable to consider travel to the Asian Pacific Rim or exposure to people from that area as a risk factor for hvKP infection. Acquisition leading to colonization and subsequent infection from International travel has been documented for Enterobacteriaceae, including cKP and hvKP 15 , 21 , 41 . Nevertheless, this risk factor has not been observed in all cases acquired outside of Asia 10 , 11 , 20 .…”

Section: Pathogenesis Of Infectionmentioning

confidence: 99%

Hypervirulent (hypermucoviscous)Klebsiella pneumoniae

2013

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A new hypervirulent (hypermucoviscous) variant of Klebsiella pneumoniae has emerged. First described in the Asian Pacific Rim, it now increasingly recognized in Western countries. Defining clinical features are the ability to cause serious, life-threatening community-acquired infection in younger healthy hosts, including liver abscess, pneumonia, meningitis and endophthalmitis and the ability to metastatically spread, an unusual feature for enteric Gram-negative bacilli in the non-immunocompromised. Despite infecting a healthier population, significant morbidity and mortality occurs. Although epidemiologic features are still being defined, colonization, particularly intestinal colonization, appears to be a critical step leading to infection. However the route of entry remains unclear. The majority of cases described to date are in Asians, raising the issue of a genetic predisposition vs. geospecific strain acquisition. The traits that enhance its virulence when compared with “classical” K. pneumoniae are the ability to more efficiently acquire iron and perhaps an increase in capsule production, which confers the hypermucoviscous phenotype. An objective diagnostic test suitable for routine use in the clinical microbiology laboratory is needed. If/when these strains become increasingly resistant to antimicrobials, we will be faced with a frightening clinical scenario.

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“…In addition, in Northern Europe, there seems to be an emergence of community‐acquired hypervirulent K. pneumoniae (serotype K1, Clonal Complex 23 (CC23)). The specific virulence characteristics of these strains constitute a risk factor for a syndrome with metastatic complications …”

Section: Introductionmentioning

confidence: 99%

HypervirulentKlebsiella pneumoniaeK1 liver abscess and endogenous endophthalmitis in a Caucasian man

Baekby

Hegedüs

Sandahl

et al. 2018

Clinical Case Reports

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Key Clinical MessageInvasive Liver Abscess Syndrome is the most frequent of a number of infectious syndromes caused by hypervirulent Klebsiella pneumoniae clones. While incidences peak in Southeast Asia, travels to Asia and Asian ethnicity are independent risk factors for infection in the western countries, although non‐Asians are infected as well. Although challenging, a prompt diagnosis is of utmost importance to ensure adequate treatment and improve overall survival and visual outcome in cases with ocular involvement.

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Monomicrobial necrotizing fasciitis in a white male caused by hypermucoviscous Klebsiella pneumoniae

Cited by 23 publications

References 17 publications

Necrotizing Fasciitis Caused by Hypermucoviscous Klebsiella pneumoniae in a Filipino Female in North America

Necrotizing Fasciitis Caused by Hypermucoviscous Klebsiella pneumoniae in a Filipino Female in North America

Hypervirulent (hypermucoviscous)Klebsiella pneumoniae

HypervirulentKlebsiella pneumoniaeK1 liver abscess and endogenous endophthalmitis in a Caucasian man

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