Invasive Klebsiella Abscess Syndrome with Subsequent Acute Respiratory Distress Syndrome: a Case Report and Review

Authors:

Martin-Lazaro JF^1*, Perkins T², Brys M¹, Napier J¹ and Tiberi S³

Volume 1, Issue 2

Abstract

Background: Invasive Klebsiella Abscess Syndrome is a newly emerging syndrome, whereby an initial Klebsiella pneumonia liver abscess causes bacterial, extra hepatic complications. It has been well described in Asian countries because of the increased prevalence of highly virulent strains, and the increased diabetic population. However, only a handful of cases have been published in Europe. Also, a case has never been published where the syndrome has resulted in an Acute Respiratory Distress Syndrome, compounding the patient management. Case Report: A 48-year-old, diabetic Asian woman presented to a London Accident and Emergency Department with abdominal pain and fever. A CT abdomen scan showed a large liver abscess which aspirated Klebsiella pneumonia, K1 strain. The same pathogen was isolated from blood cultures and thus a diagnosis of Invasive Klebsiella Abscess Syndrome was made. The infection was managed with aspiration drainage and intravenous antibiotics. The patient developed Acute Respiratory Distress Syndrome, caused by the septicemia, which required respiratory support. After lengthy treatment the patient made a full recovery. Conclusions: This is the first case reporting these two concurrent syndromes in a country where Invasive Klebsiella Abscess Syndrome has only been described in a small number of patients in recent years. This is in contrast to Asia, where it has been reported numerous times, due to the increased pathogenic prevalence. Given increasing global migration, Invasive Klebsiella Abscess Syndrome is likely to become more prevalent in non-Asian countries.

Keywords:

Klebsiella pneumonia; Adult Respiratory Distress Syndrome; Invasive Liver Abscess Syndrome; Pyogenic liver abscess; Europe; Great Britain.

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