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2013, Number 1

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Gac Med Mex 2013; 149 (1)

Liver abscess syndrome with lung involvement secondary to hypermucoviscosity Klebsiella pneumoniae

Carrillo ER, Soto HJL, Peña PCA, Carrillo CLD, Carrillo CCA, Carrillo CDM

Language: Spanish
References: 24
Page: 102-107
PDF size: 637.30 Kb.


ABSTRACT

Klebsiella pneumoniae liver abscess syndrome (KLAS) is an emerging infection characterized by primary monomicrobial liver abscess, bacteremia and metastatic complications. KLAS is endemic in Taiwan but additional cases has also been described in other world regions. It’s caused by strains of K. pneumonia serotype K1, rmpA, magA positive, displaying hypermucoviscosity. We present the case of a previously healthy 69 years old patient who developed fever, liver abscess, septic shock, bacteremia, and pneumonia. In cultures grew hypermucoviscous phenotype of K. pneumonia characterized by positive “string test”. The patient responded favourably to antibiotic therapy with ceftriaxone, meropenem, amykacin and percutaneous drainage of the abscess. Increased awareness about this globally emerging infection by physicians could allow earlier detection and optimal treatment.


REFERENCES

  1. Wang JH, Liu YC, Lee SS. Primary liver abscess due to Klebsiella pneumoniae in Taiwan. Clinic Infect Dis. 1998;26:1434-8.

  2. Tsai FC. Pyogenic liver abscess as endemic disease, Taiwan. Emerging Infect Dis. 2008;14:1592-600.

  3. Nadasy KA, Domiati-Saas R, Tribble MA. Invasive Klebsiella pneumoniae syndrome in North America. Clin Infect Dis. 2007;45:25-8.

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

  5. Hirsh EB, Tam VH. Detection and treatment options for Klebsiella pneumoniae carbapenemases (KPCs): an emerging cause of multidrug-resistant infection. J Antimicrob Chemother. 2010;65:1119-25.

  6. Yu VL, Hansen DS, Ko WC, et al. Virulence characteristics of Klebsiella and clinical manifestations of K. pneumoniae bloodstream infection. Emerg Infect Dis. 2007;13:986-93.

  7. Ko WC, Paterson DL, Sagnimeni AJ, et al. Community-acquired Klebsiella pneumoniae bacteremia: global differences in clinical patterns. Emerg Infect Dis. 2002;8:160-6.

  8. Lederman ER, Crum NF. Klebsiella liver abscess: a coast-to-coast phenomen. Clin Infect Dis. 2005;41:273.

  9. Casella F, Finazzi L, Repetti V, et al. Liver abscess caused by Klebsiella pneumoniae: two case reports. Cases J. 2009;2:6879.

  10. Fang CT, Lai SY, Yi WC, Hsueh PR, Liu KL, 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;45:284-93.

  11. Dylewski JS, Dylewski I. Necrotizing fasciitis with Klebsiella liver abscess. Clin Infect Dis. 1998;27:1561-2.

  12. Chuang YP, Fang CT, Lai SY, Chang SC, Wang JT. Genetic determinants of capsular serotype K1 of Klebsiella pneumoniae causing primary pyogenic liver abscess. J Infect Dis. 2006;193:645-54.

  13. Fang CT. A novel virulence gene in Klebsiella pneumoniae strain causing primary liver abscess and septic metastatic complications. J Exp Med. 2004;199:697-705.

  14. Vila A, Cassata A, Pagella H, et al. Appearance of Klebsiella pneumoniae liver abscess syndrome in Argentina: case report and review of molecular mechanisms of pathogenesis. Open Microbiol J. 2011;5: 107-13.

  15. Hui JY, Yang MK, Cho DH, et al. Pyogenic liver abscesses caused by Klebsiella pneumoniae: US appearance and aspiration findings. Radiology. 2007;242:769-76.

  16. Kim SB, Je BK, Lee KY, Lee SH, Chung HH, Cha SH. Computed tomographic differences of pyogenic liver abscesses caused by Klebsiella pneumoniae and non-Klebsiella pneumoniae. J Comput Assist Tomogr. 2007;31:59-65.

  17. Chuang YP, Fang CT, Lai SY, Chang SC, Wang JT. Genetic determinants of capsular serotype K1 of Klebsiella pneumoniae causing primary pyogenic liver abscess. J Infect Dis. 2006;193:645-54.

  18. Struve C, Bojer M, Nielsen EM, Hansen DS, Krogfelt KA. Investigation of the putative virulence gene MagA in a worldwide collection of 495 Klebsiella isolates: magA is restricted to the gene cluster of Klebsiella pneumoniae capsule serotype K1. J Med Microbiol. 2005;54:1111-3.

  19. Nassif X, Sansonetti PJ. Correlation of the virulence of Klebsiella pneumoniae K1 and K2 with the presence of a plasmid encoding aerobactina. Infect Immun. 1986;54:603-8.

  20. Kawai T. Hypermucoviscosity: an extremely sticky phenotype of Klebsiella pneumoniae associated with emerging destructive tissue abscess syndrome. Clin Infect Dis. 2006;42:1359-61.

  21. Chiu CH, Su LH, Wu TL, Hung IJ. Liver abscess caused by Klebsiella pneumoniae in siblings. J Clin Microbiol. 2001;39:2351-3.

  22. Keynan Y, Rubinstein E. The changing face of Klebsiella pneumoniae infection in the community. Int J Antimicrob Agents. 2007;30:385-9.

  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;100:322-31.

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




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