Primary lung abscess due to multidrug-resistant<i>Klebsiella pneumoniae</i>

Mascarenhas, Chrystle; Vishak, Acharya; Sindhu, K Sai; Mendonca, Jane

doi:10.1136/bcr-2021-244759

Cited by 5 publications

(5 citation statements)

References 14 publications

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“…In murine models, HiAlc Kpn long-term infection in the lungs could induce pulmonary fibrosis. Although it has been known that Kpn has become an increasing cause of communityacquired lung abscess 28,29 , Kpn-induced pulmonary fibrosis has been rarely reported 30 .…”

Section: Discussionmentioning

confidence: 99%

Klebsiella pneumoniae aggravates lung injury through ethanol production

Cui

et al. 2022

Preprint

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Klebsiella pneumoniae, a major pathogen leading to severe pneumonia, causes clinical complications in nosocomial and community-acquired infections. We have previously reported that high alcohol-producing K. pneumoniae (HiAlc Kpn) in the gut microbiome are strongly associated with nonalcoholic fatty liver disease (NAFLD) owing to the excess endogenous alcohol production. In the present study, we discovered that Kpn isolated from sputum and bronchoalveolar fluid (BALF) of patients with pneumoniae and chronic obstructive pulmonary disease (COPD) could also produce excess ethanol. In a murine model, HiAlc Kpn aggravated lung injury of mice with acute infection comparing with alcohol dehydrogenase gene-knockout mutant. A single-cell sequencing transcriptome analysis showed that resistin like gamma (Retnlg) neutrophil played a critical role during acute infection. The HiAlc Kpn inactivated Retnlg neutrophils in an ethanol production-dependent manner in mice, which counteract immune defense possibly through down-regulating pyrimidine and modifying DNA methylation. Furthermore, data also showed that HiAlc Kpn inhibited interleukin 1 receptor antagonist (IL1RN) gene expression by neutrophils, thereby activating IL-1β to orchestrate immune responses. Understanding functions of Retnlg neutrophils and IL-1β release in the context of HiAlc Kpn and host interactions are essential for developing novel therapeutic strategies.

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Section: Discussionmentioning

confidence: 99%

Klebsiella pneumoniae aggravates lung injury through ethanol production

Cui

et al. 2022

Preprint

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“…It is possible that inadequate antibiotic intensity and duration of treatment administered at local hospitals contributed to the development of multidrug-resistant bacteria. Without the prompt initiation of sensitive antibiotics, the prostate abscess might progress further, potentially leading to the infection of distant organs ( Chrystle et al, 2021 ; Kam et al, 2019 ; Mücke et al, 2017 ). Hence, the judicious selection of sensitive antibiotics, coupled with adequate dosage and duration of treatment, is of paramount importance in the management of prostate abscesses.…”

Section: Discussionmentioning

confidence: 99%

Giant Prostate Abscess: A Case Report and Literature Review

Liang,

Cao,

Qin

et al. 2023

Am J Mens Health

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Prostate abscess, a rare condition often associated with prostate bacterial infections, often occurs in immunosuppressive individuals and manifests as fever and lower urinary tract symptoms. Clinical practice lacks standardized diagnostic and treatment protocols for prostate abscesses, resulting in predominantly empirical approaches with uncertain outcomes. This study presents a case of a giant prostate abscess, diagnosed in a patient exhibiting fever, lower urinary tract symptoms (including dysuria, urinary frequency, urgency, and weakness), and anal pain. The diagnosis was confirmed through prostate magnetic resonance imaging and transrectal color ultrasound examinations. Treatment included targeted anti-infective therapy (based on the urine culture results), urine flow diversion (suprapubic bladder puncture stomy), ultrasound-guided perineal puncture drainage of the prostatic abscess, intermittent abscess cavity irrigation, and urethral electroprostatectomy. The patient experienced a complete recovery and significantly improved quality of life. This successful case underscores several key points: (1) the importance of targeted anti-infective therapy based on etiological findings in prostate abscess treatment; (2) early urine flow diversion, precise puncture drainage, and intermittent abscess cavity irrigation may be one of crucial elements in abscess management; (3) the potential significance of transurethral prostate resection following abscess resolution in preventing recurrence. It is hoped that this case report offers new valuable insights for diagnosing and treating prostate abscesses. Slightly different from previous treatment experience, we extra used early urine diversion, intermittent abscess cavity irrigation, and etiological electroprostatectomy, which might also hold promise as potential therapies.

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“…The patient underwent insufficient antibiotic intensity and treatment course before attending our medical center. As a result, the development of multi-drug-resistant features of the gram-negative bacilli might contribute to disseminating prostatic abscess to the spleen ( Chrystle et al, 2021 ; Mucke et al, 2017 ). However, blood and urine cultures suggested that amikacin was also a sensitive alternative, in this case, practical usage of carbapenems antibiotics was reported to shorten the postinfection length of stay and benefited the patient eventually ( Zilberberg et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Prostatic Abscess Combined With Spleen Abscess Due to Multi-Drug-Resistant Gram-Negative Bacilli: A Case Report and Literature Review

Sun

et al. 2022

Am J Mens Health

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The prostatic abscess is a rare complication of a bacterial infection of the prostate. Since the early use of potent antibiotics to treat urinary tract infections, the incidence of the prostatic abscess has declined significantly. In keeping with that, prostatic abscess combined with abscesses in the spleen or other distant organs become an extremely rare but fatal clinical condition. Here, we present a case of prostate and spleen abscess due to multi-drug-resistant gram-negative bacilli without obvious risk factors. The patient initially complained of high-grade fever and dysuria. After screening the source of infection by computed tomography (CT) scans, prostate and spleen abscesses were diagnosed. In addition, extended-spectrum beta-lactamase positive Escherichia coli was detected both in urine and blood culture. The patient was successfully treated by a transurethral resection of the prostate followed by splenic puncture and drainage, as well as intravenous administration of meropenem. Although the prostate abscess combined with spleen abscess was rare, the possibility of dissemination in remote tissues should be taken into consideration before the surgical treatment of prostatic abscesses. The concurrent drainage of multiple abscesses followed by intensive and sensitive antibiotics was safe and effective for indicated patients.

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Primary lung abscess due to multidrug-resistantKlebsiella pneumoniae

Cited by 5 publications

References 14 publications

Klebsiella pneumoniae aggravates lung injury through ethanol production

Klebsiella pneumoniae aggravates lung injury through ethanol production

Giant Prostate Abscess: A Case Report and Literature Review

Prostatic Abscess Combined With Spleen Abscess Due to Multi-Drug-Resistant Gram-Negative Bacilli: A Case Report and Literature Review

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