First case of Klebsiella pneumoniae invasion syndrome caused by trauma

Abstract

Background Infection is a common and serious medical problem, especially for patients with chronic diseases since it can lead to serious complications. Infection is a common and serious medical problem, especially for patients with chronic diseases since it can lead to serious complications. Klebsiella pneumoniae (Kp) is a common bacterial pathogen of hospital and community infections. In addition to causing liver abscess, it can also lead to lung abscess, endophthalmitis, meningitis and other extrahepatic infections through blood transmission, resulting in Klebsiella pneumoniae invasion syndrome (KPIS). As a rare and severe infectious disease, KPIS is characterized by aggressive infection of multiple organs, whose mortality is high. According to the literature, the Kp strains associated with invasive infection of multiple human organs are defined as the serotype hypervirulent Klebsiella pneumoniae (hvKp). In recent years, the morbidity of KPIS has gradually increased, especially in the Asia-Pacific region, with the detection rate of hvKp in China being 5.2%, which is among the top 3 in the world. Case presentation To our knowledge, this is the first case of KPIS caused by trauma. A 72-years-old male patient living in Liuzhou, Guangxi Zhuang Autonomous Region, China was admitted to the intensive care unit (ICU) with "right frontal pain caused by a fall for 12 days, and dyspnea and abnormal mental behavior for 11 hours". After his condition stabilized, he was transferred to the department of neurology for further treatment. After a thorough examination by a multidisciplinary team (MDT), the patient was finally diagnosed as trauma-induced KPIS with accompanying liver abscess, bacteremia and metastatic infections (lung abscess, left endophthalmitis, suppurative meningitis). We adopted treatments including a long course of meropenem, cefoperazone sulbactam sodium combined with antibiotic therapy, supportive nursing and rehabilitation, achieving excellent efficacy. Conclusion Although infection from injury is a common condition for the general public, especially those with diabetes, it is still necessary to increase awareness of managing and preventing complications from infection. We hope to supplement the existing literature on this topic, strive to increase clinicians' understanding of KPIS through relevant literature review, and organize MDT consultation as soon as possible, thereby enabling early diagnosis and treatment to improve the clinical outcome of patients.