PrimaryKlebsiella pneumoniaeOsteomyelitis with Bacteremia and Sepsis in a Patient with Cirrhosis

Abstract

Osteomyelitis is commonly caused by Staphylococci, Streptococci, Escherichia coli, and anaerobes. There have been cases of rare organisms like Klebsiella pneumoniae (Kp) being initially overlooked as causes of osteomyelitis. We report a case of an elderly cirrhotic adult male transferred for further management of liver failure, who was subsequently diagnosed with Kp osteomyelitis and sepsis. He had a history of blunt leg trauma, and MRI of the leg revealed osteomyelitis, with a negative workup for other sources of infection. Kp osteomyelitis is reported in less than 100 cases, mainly in pediatric and sickle-cell patients. There are no pathognomonic imaging findings. Lesions may be metastatic, with rapid widespread destruction and exuberant periosteal reaction. Kp is a rare, under recognized cause of osteomyelitis in immune-suppressed adults. Given its pathogenicity, early identification is critical.

Suture fixation of traumatic rib fracture flail segment with Klebsiella osteomyelitis

“…Causative organisms are typically Staphylococcus aureus , Staphylococcus epidermidis , Enterococcus , Pseudomonas , Escherichia coli , anaerobes, and Mycobacterium tuberculosis [ 11 , 12 ]. Rib osteomyelitis secondary to Klebsiella pneumoniae is extremely rare and has only been reported in the pediatric or immunocompromised population [ [13] , [14] , [15] ].…”

Acute femoral osteomyelitis due to hypermucoviscous Klebsiella pneumoniae

“…It has been reported to cause septic arthritis and osteomyelitis, mostly in children [1] , but uncommonly in adults. Hypervirulent hypermucoviscous K. pneumoniae strains have been implicated in invasive infections including bacteremia, liver abscesses, and meningitis [2] , but there are few reports of osteomyelitis [2] , [3] , [4] . Of note, most of these cases include patients with positive blood cultures and underlying diseases, such as diabetes [2] , [3] , [4] .…”

“…Hypervirulent hypermucoviscous K. pneumoniae strains have been implicated in invasive infections including bacteremia, liver abscesses, and meningitis [2] , but there are few reports of osteomyelitis [2] , [3] , [4] . Of note, most of these cases include patients with positive blood cultures and underlying diseases, such as diabetes [2] , [3] , [4] . Here, we report a case of osteomyelitis caused by hypermucoviscous K. pneumoniae as the primary infection in an adult patient who was initially admitted for the suspicion of a bone tumor.…”

Constituents, Antibacterial Adhesion, Cytotoxic and in Vitro Metastasis Blocking Properties of Salvia fruticosa Essential Oils from Three Palestinian Localities

“…It is estimated that antibiotic resistance is responsible for 700,000 deaths each year, and that number could rise to 10 million by the year 2050 [13] . Certain clinical conditions are undoubtedly brought on by K. pneumoniae , including wound infection, thrombophlebitis, cholecystitis, upper respiratory tract infection, diarrhea, urinary tract infection, osteomyelitis, sepsis, bacteremia, meningitis, and pneumonia [14] …”