Carrillo-Esper R, Díaz-Carrillo MA, Peña-Pérez C

Idioma: Español
Referencias bibliográficas: 23
Paginas: 533-536
Archivo PDF: 187.54 Kb.

RESUMEN

El síndrome de absceso hepático asociado con Klebsiella pneumoniae hipermucoviscosa es un padecimiento infeccioso emergente. Se describió por primera vez en el sureste asiático, sobre todo en Taiwán y hace poco se reportaron algunos casos aislados en otras regiones, incluida la de México. Lo originan las cepas de Klebsiella pneumoniae serotipo K1, rmpA y MagA positivas, que le confieren la característica de hipermucoviscosidad. Se reporta el caso de un paciente masculino de 58 años de edad, con antecedente de diabetes mellitus con un cuadro de fiebre, ataque al estado general y dolor abdominal en el cuadrante superior derecho. La TAC de abdomen mostró una imagen hipodensa en el segmento 1, compatible con absceso hepático. Del material purulento se aisló Klebsiella pneumoniae hipermucoviscosa. El enfermo reaccionó favorablemente al drenaje del absceso y tratamiento con ceftriaxona y amikacina. Al evaluar a pacientes con absceso hepático, en los diagnósticos diferenciales, debe considerarse el síndrome de absceso hepático asociado con Klebsiella pneumoniae hipermucoviscosa.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Siu KL, Yeh KM, Lin JC, Fung CP, Chang FY. Klebsiella pneumoniae liver abscess: a new invasive syndrome. Lancet Infect Dis 2012;12:881-887.

2. Wang JH, Liu YC, Lee SS. Primary liver abscess due to Klebsiella pneumoniae in Taiwan. Clinic Infect Dis 1998;26:1434-1438.

3. Lederman ER, Crum NF. Pyogenic liver abscess with a focus on Klebsiella pneumoniae as a primary pathogen: an emerging disease with unique clinical characteristics. Am J Gastroenterol 2005;100:322-331.

4. Fierer J. Biofilm formation and Klebsiella pneumoniae liver abscess. True, true and unrelated? Virulence 2012;3:241- 242.

5. Fang FC, Sandler N, Libby SJ. Liver abscess caused by magA Klebsiella pneumoniae in North America. J Clin Micr 2005;43:991-992.

6. Carrillo ER, Soto JL, Peña PC, Carrillo CL, Carrillo CA, Carrillo CD. Síndrome de absceso hepático secundario a Klebsiella pneumoniae hipermucoviscosa con involucro pulmonar. Gac Med Mex 2013: 149; 102-107.

7. Nadasy KA, Domiati-Saad R, Tribble MA. Invasive Klebsiella pneumonia syndrome in North America. Clin Inf Dis 2007;45:e25-28.

8. Echeverri LM, Cataño JC. Klebsiella pneumoniae como patógeno intrahospitalario: epidemiología y resistencia. Iatreia 2010; 23: 240-249.

9. Podschun R, Ullmann U. Klebsiella spp as a nosocomial pathogens: epidemiology, taxonomy, typing methods and pathogenicity factors. Clin Microbiol Rev 1998;11:589-603.

10. Fang CT, Lai SY, Yi WC, Hsueh PR, Liu K-L, Chang SC. Klebsiella pneumoniae genotype K1: An emerging pathogen that causes septic ocular or central nervous system complications from pyogenic liver abscess. Clin Infect Dis 2007;45:284-293.

11. Fung CP, Lin YT, Lin JC, Chen TL, Yeh KM, Chang FY, et al. Klebsiella pneumoniae in gastrointestinal tract and pyogenic liver abscess. Emerg Infect Dis 2012;18:1322- 1325.

12. Yeh KM, Lin JC, Yin FY, Fung CP, Hung HC, Siu LK, Chang FY. Revisiting the importance of virulence determinant magA and Its surrounding genes in Klebsiella pneumoniae causing pyogenic liver abscesses: Exact role in serotype K1 capsule formation. J Infect Dis 2010:201;1259-1267.

13. Lee HC, Chuang YC,Yu WL, Lee NY, Chang CM, Ko NY, et al. Clinical implications of hypermucoviscosity phenotype in Klebsiella pneumoniae isolates: association with invasive syndrome in patients with community-acquired bacteraemia. J Int Med 2006; 259: 606-614.

14. Wu MC, Lin TL, Hsieh PF, Yang HC, Wang JT. Isolation of genes involved in biofilm formation of a Klebsiella pneumoniae strain causing pyogenic liver abscess. PLoS ONE 2011;6:1-11.

15. Yu WL, Ko WC, Cheng KC, Lee HC,4 Ke DS, Lee CC, et al. Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan. CID 2006;42:1351-1358.

16. Sobirk SK, Struve C, G Jacobsson SG. Primary Klebsiella pneumoniae liver abscess with metastatic spread to lung and eye, a North-European case report of an emerging syndrome. Op Micr J 2010;4:5-7.

17. Vila A, Cassata A, Pagella H, Amadio C, Yeh KM, Chang FY. Appearance of Klebsiella pneumoniae liver abscess syndrome in Argentina: Case report and review of molecular mechanisms of pathogenesis. The Op Micr J 2011;5:107-113.

18. Foo N-P, Chen K-T, Lin H-J, Guo H-R. Characteristics of pyogenic liver abscess patients with and without diabetes mellitus. Am J Gastroenterol 2010; 105:328-335.

19. Casella F, Finazzi L, Repetti V, Rubin G, DiMarco M, Mauro T, et al. Liver abscess caused by Klebsiella pneumoniae: two case reports. Cas Jour 2009; 2: 6879-6883.

20. Alsaif HS, Venkatesh SK, Chan DSG, Archuleta S. CT Appearance of pyogenic liver abscesses caused by Klebsiella pneumoniae. Radiology 2011; 260: 129-138.

21. Lee NK, Kim S, Lee JW, Jeong J, Lee SH, Heo J, et al. CT differentiation of pyogenic liver abscesses caused by Klebsiella pneumoniae vs non-Klebsiella pneumoniae. Br J Radiol 2011; 84:518-525.

22. Keynan Y, Rubinstein E. The changing face of Klebsiella pneumoniae infection in the community. Int J Antimicrob Agents 2007;30:385-389.

23. Lederman ER, Crum NF. Pyogenic liver abscess with a focus on Klebsiella pneumoniae as a primary pathogen: an emerging disease with unique clinical characteristics. Am J Gastroenterol 2005;100:322-331.