A case of lobar pneumonia and sepsis with death caused by invasive Klebsiella rhinoscleromatis infection

Eri Kumade, Norihiro Furusyo, Norito Takeshima, Yasuhiro Kishihara, Fujiko Mitsumoto-Kaseida, Yoshitaka Etoh, Murata Masayuki, Jun Hayashi

Research output: Contribution to journalArticle

Abstract

Klebsiella pneumoniae often causes pneumonia and other infections in heavy drinkers and patients with diabetes. Pneumonia caused by Klebsiella rhinoscleromatis, a subspecies of K. pneumoniae, has not been previously reported. We report a case of pneumonia caused by K. rhinoscleromatis. A 68-year-old man with type 2 diabetes visited our department complaining fever and fatigue for 10 days and cough and bloody sputum for two days. His Japan Coma Scale score was I-1, body temperature 38.3 °C, blood pressure 85/51 mmHg, pulse 135 bpm, and peripheral capillary oxygen saturation level 92% (room air). He had no abnormal breathing sounds. His white blood cell count had decreased to 2600/μL, and his C-reactive protein level was high, at 35.9 mg/dL. Chest computed tomography revealed lobar pneumonia in the right upper lobe and pneumonia in the left upper division. Klebsiella was suspected based on the result of a sputum smear examination. He was diagnosed with septic shock due to pneumonia and was immediately admitted. Intravenous antibacterial (levofloxacin) treatment was initiated, however, he died 13 h after presenting at the hospital. Subsequently, K. rhinoscleromatis was detected in sputum and blood culture. Additional testing determined the bacteria to be a highly pathogenic hypermucoviscosity phenotype and the cause of the fatal lobar pneumonia. Although cases of rhinoscleroma and bacteremia caused by K. rhinoscleromatis infection have been reported, this is the first report of a case with sepsis caused by fulminant pneumonia.

Original languageEnglish
Pages (from-to)707-711
Number of pages5
JournalJournal of Infection and Chemotherapy
Volume22
Issue number10
DOIs
Publication statusPublished - Oct 1 2016

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Klebsiella Infections
Klebsiella pneumoniae
Sepsis
Pneumonia
Sputum
Rhinoscleroma
Levofloxacin
Klebsiella
Respiratory Sounds
Coma
Septic Shock
Bacteremia
Infection
Body Temperature
Leukocyte Count
Cough
C-Reactive Protein
Type 2 Diabetes Mellitus
Fatigue
Pulse

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Kumade, E., Furusyo, N., Takeshima, N., Kishihara, Y., Mitsumoto-Kaseida, F., Etoh, Y., ... Hayashi, J. (2016). A case of lobar pneumonia and sepsis with death caused by invasive Klebsiella rhinoscleromatis infection. Journal of Infection and Chemotherapy, 22(10), 707-711. https://doi.org/10.1016/j.jiac.2016.03.004

A case of lobar pneumonia and sepsis with death caused by invasive Klebsiella rhinoscleromatis infection. / Kumade, Eri; Furusyo, Norihiro; Takeshima, Norito; Kishihara, Yasuhiro; Mitsumoto-Kaseida, Fujiko; Etoh, Yoshitaka; Masayuki, Murata; Hayashi, Jun.

In: Journal of Infection and Chemotherapy, Vol. 22, No. 10, 01.10.2016, p. 707-711.

Research output: Contribution to journalArticle

Kumade, E, Furusyo, N, Takeshima, N, Kishihara, Y, Mitsumoto-Kaseida, F, Etoh, Y, Masayuki, M & Hayashi, J 2016, 'A case of lobar pneumonia and sepsis with death caused by invasive Klebsiella rhinoscleromatis infection', Journal of Infection and Chemotherapy, vol. 22, no. 10, pp. 707-711. https://doi.org/10.1016/j.jiac.2016.03.004
Kumade, Eri ; Furusyo, Norihiro ; Takeshima, Norito ; Kishihara, Yasuhiro ; Mitsumoto-Kaseida, Fujiko ; Etoh, Yoshitaka ; Masayuki, Murata ; Hayashi, Jun. / A case of lobar pneumonia and sepsis with death caused by invasive Klebsiella rhinoscleromatis infection. In: Journal of Infection and Chemotherapy. 2016 ; Vol. 22, No. 10. pp. 707-711.
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