Zhang JQ, He CC, Yuan B, Liu R, Qi YJ, Wang ZX, He XN, Li YM. Fatal systemic emphysematous infection caused by Klebsiella pneumoniae: A case report. World J Clin Cases 2022; 10(8): 2610-2615 [PMID: 35434061 DOI: 10.12998/wjcc.v10.i8.2610]
Corresponding Author of This Article
Yu-Min Li, MD, PhD, Chief Physician, Professor, Department of General Surgery, Lanzhou University Second Hospital, No. 82 Cuiyingmen Road, Lanzhou 730030, China. liym@lzu.edu.cn
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 16, 2022; 10(8): 2610-2615 Published online Mar 16, 2022. doi: 10.12998/wjcc.v10.i8.2610
Fatal systemic emphysematous infection caused by Klebsiella pneumoniae: A case report
Jun-Qiang Zhang, Chan-Chan He, Bo Yuan, Rui Liu, Yu-Jing Qi, Zi-Xia Wang, Xiao-Na He, Yu-Min Li
Jun-Qiang Zhang, Chan-Chan He, Bo Yuan, Rui Liu, Yu-Jing Qi, Zi-Xia Wang, Xiao-Na He, Yu-Min Li, Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
Author contributions: Zhang JQ and He CC designed the report; Zhang JQ wrote the manuscript; Liu R and Wang ZX collected the patient’s clinical data; Yuan B, Qi YJ, and He XN were the attending doctors and performed clinical treatment; Li YM revised the paper.
Supported bythe National Natural Science Foundation of China, No. 81560480; Health Science Research Program of Gansu Province, No. GSWSKY 2016-19; Ph.D. Science Research Foundation of Lanzhou University Second Hospital, No. ynbskyjj 2015-1-09; and Cuiying Scientific and Technological Innovation Program of Lanzhou University Second Hospital, No. CY 2018-MS13.
Informed consent statement: Informed consent has been obtained and is available from the corresponding author.
Conflict-of-interest statement: All authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: We wrote the manuscript based on the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Min Li, MD, PhD, Chief Physician, Professor, Department of General Surgery, Lanzhou University Second Hospital, No. 82 Cuiyingmen Road, Lanzhou 730030, China. liym@lzu.edu.cn
Received: October 17, 2021 Peer-review started: October 17, 2021 First decision: December 3, 2021 Revised: December 26, 2021 Accepted: February 10, 2022 Article in press: February 10, 2022 Published online: March 16, 2022 Processing time: 144 Days and 7.3 Hours
Abstract
BACKGROUND
Systemic emphysematous infection caused by Klebsiella pneumoniae (K. pneumoniae) is a rare but severe infection which can be lethal if the diagnosis is delayed.
CASE SUMMARY
We report a rare case of systemic emphysematous infection via hematogenous dissemination from a liver abscess caused by K. pneumoniae, complicated by multiple organ dysfunction syndrome, septic shock, bacteremia, emphysematous cystitis, prostate and left seminal vesicle abscesses in a diabetic patient. The patient simultaneously presented with spontaneous pneumoperitoneum secondary to rupture of the emphysematous liver abscess. His condition after admission deteriorated rapidly and he died within a short period. This disease is a great challenge for the clinician as K. pneumoniae can cause multifocal emphysematous infections and fulminant septic shock. Pneumoperitoneum following spontaneous rupture of the liver abscess can result in intra-abdominal sepsis that further increases mortality rate. Moreover, appropriate site-specific intervention and adequate drainage of numerous emphysematous liver lesions are difficult.
CONCLUSION
Early diagnosis followed by efficient antibiotic therapy and surgical management are essential for systemic emphysematous infection.
Core Tip: Systemic emphysematous infection caused by Klebsiella pneumoniae is a rare but lethal infection. The combination of emphysematous liver abscess, emphysematous cystitis, prostate and left seminal vesicle abscesses, bacteremia, septic shock and multiple organ dysfunction syndrome are even rarer. The patient simultaneously presented with spontaneous pneumoperitoneum secondary to rupture of the emphysematous liver abscess, which is an extremely rare clinical condition inducing intra-abdominal sepsis that further increases the mortality rate.
