Fatal Klebsiella pneumoniae meningitis and concomitant disseminated intravascular coagulation in a patient with diabetes mellitus

Abstract

Bacterial meningitis remains a major cause of death and long-term neurologic sequelae worldwide. We present a case of fatal Klebsiella pneumoniae meningitis and concomitant disseminated intravascular coagulation (DIC) in a 72-year-old woman with diabetes mellitus (DM). Both blood and cerebrospinal fluid cultures grew Klebsiella pneumoniae. Due to advanced age, newly recognized DM, K. pneumoniae bacteremia, and DIC, the prognosis of our patient was poor. Eight hours after arrival to the emergency department, cardiopulmonary resuscitation was necessary in this patient, but she died despite an early diagnosis and appropriate antibiotic therapy.

A Rare Case of Third Generation Cephalosporin-Resistant Klebsiella Meningitis

“…Studies have associated Klebsiella meningitis with preceding diseases like diabetes, disseminated intravascular coagulation, and liver abscesses [3,6]. However, despite a comprehensive medical, surgical, and family history along with the examination and a series of tests, this patient had neither of these conditions or any other associated co-morbidities.…”

Community acquired Klebsiella pneumoniae meningitis: a case report

“…5 Clinical outcomes for Klebsiella pneumoniae meningitis have been poor as similar cases have led to disseminated intravascular coagulation (DIC) and even recurrent infection. [6][7][8] Community acquired Klebsiella pneumoniae meningitis, although rare in the United States, commonly causes rapid deterioration of mental status and high mortality. [6][7] Case reports from Taiwan, Thailand, and Hong Kong report higher incidence with diabetes, alcoholism and chronic liver disease.…”

“…[6][7][8] Community acquired Klebsiella pneumoniae meningitis, although rare in the United States, commonly causes rapid deterioration of mental status and high mortality. [6][7] Case reports from Taiwan, Thailand, and Hong Kong report higher incidence with diabetes, alcoholism and chronic liver disease. 9 In a study performed in Taiwan, patients with community acquired Klebsiella pneumoniae meningitis were more likely to have preceding infections such as pyogenic liver abscess, septic endophthalmitis, pneumonia, otitis media, urinary tract infection, lumbar discitis and perianal abscess, 8 while hospital acquired Klebsiella pneumoniae meningitis cases were more likely to have undergone neurosurgical procedures.…”

Intradermal Immunization of BALB/C Mice with Heat Killed Klebsiella pneumoniae ATCC BAA1706 Leads to the Production of both IgG1 and IgG2a

“…In addition to pneumonia, K. pneumoniae strains have been isolated from other severe medical conditions, such as sepsis, the formation of pyogenic liver abscess, urinary tract infections, meningitis and endophthalmitis (Ho, Tsai et Liao, 2009;…”