Metastatic infection caused by hypervirulent Klebsiella pneumonia and co-infection with Cryptococcus meningitis: A case report

作     者：Yun-Feng Shi Yu-Kai Wang Yan-Hong Wang Hui Liu Xiao-Han Shi Xiao-Jie Li Ben-Quan Wu 

作者机构：Medical Intensive Care UnitDepartment of Respiratory and Critical Care MedicineThird Affiliated Hospital of Sun Yat-Sen UniversityGuangzhou 510630Guangdong ProvinceChina Institute of Respiratory DiseasesSun Yat-Sen UniversityGuangzhou 510630Guangdong ProvinceChina Department of Laboratory MedicineThird Affiliated Hospital of Sun Yat-Sen UniversityGuangzhou 510630Guangdong ProvinceChina 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2019年第7卷第22期

页      面：3812-3820页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Supported by Science and Technology Planning Project of Guangdong Province of China No.2017A020215177 

主　　题：Hypervirulent Klebsiella pneumoniae Metastatic infection Cryptococcusneoformans meningitis Comorbidity Case report 

摘      要：BACKGROUND Klebsiella pneumoniae(K.pneumoniae)used to affect mainly people with compromised immunity or weakened by other infections,but recent emergence of hypervirulent strains has increased infections even in healthy individuals.These infections include liver abscess,pneumonia,bacteremia,meningitis,necrotizing fasciitis,and endophthalmitis.Although metastatic infection by hypervirulent K.pneumoniae(hvKP)is increasingly recognized,co-infection with Cryptococcus neoformans(C.neoformans)meningitis in immunocompetent hosts is rare but fatal.So,it is necessary to determine the risk factors,complications,and comorbidity of this disease.CASE SUMMARY This report describes a 58-year-old man with hvKP pulmonary abscess,bacteremia,and meningitis,accompanied by fatal Cryptococcus meningitis.This patient presented with fever for 1 wk and drowsiness for 3 d.Laboratory findings revealed pulmonary abscess and bacteremia of K.pneumoniae.He was given intravenous antibiotic therapy,and the infection was under control for about 1 wk.However,his condition deteriorated rapidly because of metastatic purulent meningitis.Although hvKP and C.neoformans were isolated and confirmed,the patient died of spontaneous respiratory and cardiac arrest caused by cerebral hernia.CONCLUSION HvKP has emerged as a cause of metastatic infections in immunocompetent hosts.polymicrobial co-infections should be taken into consideration when metastatic infection is present.