Severe intracranial infection caused by hypervirulent Klebsiella pneumoniae: a case report
10.3760/cma.j.cn113694-20210810-00550
- VernacularTitle:高毒力肺炎克雷伯菌致重症颅内感染1例
- Author:
Ping ZHANG
1
;
Feng XU
;
Qiming LIANG
;
Lifei LIAN
;
Furong WANG
Author Information
1. 华中科技大学同济医学院附属同济医院神经内科，武汉 430030
- Keywords:
Klebsiella pneumoniae;
Meningitis, bacterial;
Brain abscess;
Carbapenem-resistant Klebsiella pneumoniae
- From:
Chinese Journal of Neurology
2022;55(3):229-233
- CountryChina
- Language:Chinese
-
Abstract:
Hypervirulent Klebsiella pneumoniae (HvKP) is a new variant of Klebsiella pneumoniae. It is characterized by strong virulence and easy dissemination. It mainly causes liver abscess with multiple invasive infections, including eye, lung and central nervous system, with a high fatality rate. A case of severe intracranial infection caused by HvKP was reported. The patient was a 44-year-old formerly healthy man. He had acute onset of fever, headache, and disturbance of consciousness, which rapidly progressed to intracranial hypertension and respiratory failure. Cerebrospinal fluid examination suggested purulent infection, and bacterial culture suggested Klebsiella pneumoniae, which was sensitive to other commonly used antibiotics except ampicillin. Brain magnetic resonance imaging showed multiple abnormal signals in bilateral frontal, parietal and temporal lobes, right centrum semiovale, bilateral corona radiata, basal ganglia, thalamus and insula, as well as enhancement of meningeal and ependymal membrane, and swelling of brain tissue. During hospitalization, the patient developed a blood stream infection of pan-drug-resistant Klebsiella pneumoniae and was in critical condition. After aggressive treatment, the patient was cured and discharged from the hospital. After half a year follow-up, his prognosis was good and his social function was restored. The clinical data, diagnosis and treatment of the patient were reported and the literature was reviewed to provide clinical reference for the disease.
