1.Septic monoarthritis and osteomyelitis in an elderly man following Klebsiella pneumoniae genitourinary infection: case report.
Annals of the Academy of Medicine, Singapore 2006;35(2):100-103
INTRODUCTIONKlebsiella pneumoniae septic arthritis and osteomyelitis, albeit uncommon in adults, are important sites of disseminated infection. Many case reports have shown K. pneumoniae as a cause of nosocomial transmitted septic arthritis in neonates and children. We report a rare case of an elderly patient with K. pneumoniae genitourinary infection spreading to the liver and other extra hepatic sites like the prostate and peripheral joint.
CLINICAL PICTUREThe patient presented with a short history of general malaise, fever and urinary symptoms, associated with an acute monoarthritis of the ankle. On admission, he was in septic shock. Investigations suggested an infective cause, as evidenced by raised total white cell count and pyuria. K. pneumoniae was cultured from both urine and ankle synovial fluid. Imaging confirmed multiple liver and prostatic abscesses, as well as osteomyelitis of the foot bones adjacent to the ankle.
TREATMENTTreatment in this case included surgical drainage of the affected joint and surrounding soft tissue structures, in addition to a 6-week course of systemic antibiotics.
OUTCOMEThe patient had good clinical response following treatment. In addition, we noted a normalisation of his laboratory parameters and resolution of the intraabdominal and pelvic abscesses.
CONCLUSIONThis case emphasises the importance of timely and accurate diagnosis followed by appropriate treatment in disseminated K. pneumoniae infection to prevent significant morbidity and mortality.
Aged ; Ankle Joint ; microbiology ; surgery ; Anti-Bacterial Agents ; therapeutic use ; Arthritis, Infectious ; diagnosis ; microbiology ; therapy ; Combined Modality Therapy ; Drainage ; Foot Bones ; microbiology ; Humans ; Klebsiella Infections ; diagnosis ; therapy ; Klebsiella pneumoniae ; Liver Abscess ; microbiology ; Magnetic Resonance Imaging ; Male ; Osteomyelitis ; drug therapy ; epidemiology ; microbiology ; surgery ; Prostatic Diseases ; microbiology ; Synovial Fluid ; microbiology ; Tomography, X-Ray Computed ; Urinary Tract Infections ; drug therapy ; microbiology
2.Splenic Abscess: A Single Institution Study and Review of the Literature.
Won Suk LEE ; Sang Tae CHOI ; Keon Kuk KIM
Yonsei Medical Journal 2011;52(2):288-292
PURPOSE: The aim of this study was to review our experience with splenic abscesses, with respect to the relevant aspects of splenic abscesses and treatment outcomes. MATERIALS AND METHODS: We reviewed the cases of 18 patients who had splenic abscesses and who were treated at our hospital from November 1993 to December 2008. RESULTS: The most common symptom at presentation was abdominal pain in 12 patients (66.7%). The median duration from symptom onset until establishment of a diagnosis was 22 days. Streptococcus viridians was the most common pathogen (27.8%), follow by Klebsiella pneumoniae (22.2%). The mortality rate during the inpatient period and the previous 90 days was 16.6%. Three of four patients with Klebsiella pneumoniae showed a single abscess pocket. Four patients (22.2%) underwent percutaneous drainage, eight (44.5%) recieved antibiotic treatment only and six (33.3%) underwent splenectomy. CONCLUSION: There is no gold standard for treating splenic abscesses. Treatment should be customized for each patient.
Abscess/diagnosis/drug therapy/microbiology/surgery/*therapy
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Adult
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Aged
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Anti-Bacterial Agents/therapeutic use
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Drainage
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Female
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Humans
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Klebsiella Infections/diagnosis/drug therapy/microbiology/surgery
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Klebsiella pneumoniae
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Male
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Middle Aged
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Splenectomy
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Splenic Diseases/diagnosis/drug therapy/*microbiology/surgery
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Streptococcal Infections/diagnosis/drug therapy/microbiology/surgery
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Treatment Outcome
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Viridans Streptococci
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Young Adult
3.Native valve endocarditis due to extended spectrum beta-lactamase producing Klebsiella pneumoniae.
Hyun Ae JUNG ; Young Eun HA ; Damin KIM ; Jihyun PARK ; Cheol In KANG ; Doo Ryeon CHUNG ; Seung Woo PARK ; Ki Ik SUNG ; Jae Hoon SONG ; Kyong Ran PECK
The Korean Journal of Internal Medicine 2014;29(3):398-401
No abstract available.
Aged
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Anti-Bacterial Agents/therapeutic use
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Aortic Valve/*microbiology/surgery/ultrasonography
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Cross Infection/diagnosis/*microbiology/therapy
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Diffusion Magnetic Resonance Imaging
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Endocarditis, Bacterial/diagnosis/*microbiology/therapy
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Heart Valve Prosthesis Implantation
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Humans
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Klebsiella Infections/diagnosis/*microbiology/therapy
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Klebsiella pneumoniae/drug effects/*enzymology/pathogenicity
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Male
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Microbial Sensitivity Tests
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Predictive Value of Tests
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Sepsis/diagnosis/*microbiology/therapy
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Treatment Outcome
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beta-Lactamases/*metabolism