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http://dx.doi.org/10.3904/kjm.2013.85.5.540

Necrotizing fasciitis and psoas abscess caused by hypervirulent Klebsiella pneumoniae  

Jin, Su Sin (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Kim, Youn Jeong (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Kim, Sang Il (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Hu, Joo Yeun (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Kim, Yu Seung (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Cho, Sung Yeon (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Kang, Moon Won (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
Publication Information
The Korean Journal of Medicine / v.85, no.5, 2013 , pp. 540-544 More about this Journal
Abstract
A 62-year-old diabetic female was admitted to the hospital with fever and pain in both legs. Computed tomography scans of the abdomen revealed necrotizing fasciitis of the right thigh extending into the abdominal wall, and abscesses on the right psoas muscle. Magnetic resonance imaging showed increased T2 signal intensity along the peroneus muscle and fascia of the lower left leg. The patient received antibiotics and underwent debridement of the infected and necrotic tissue. Intra-abdominal abscesses were drained. Blood and pus cultures showed growth of Klebsiella pneumoniae, as had been suspected due to string test results showing hypermucoviscosity. Free-skin grafts were performed to repair tissue loss and the patient was subsequently discharged 82 days after admission. This represents the first reported case of necrotizing fasciitis and psoas muscle abscess caused by a hypervirulent strain of K. pneumoniae in Korea.
Keywords
Hypervirulent; Hypermucoviscous; Klebsiella pneumoniae; Necrotizing fasciitis; Abscess;
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1 Fang CT, Chuang YP, Shun CT, Chang SC, Wang JT. A novel virulence gene in Klebsiella pneumoniae strains causing primary liver abscess and septic metastatic complications. J Exp Med 2004;199:697-705.   DOI   ScienceOn
2 Shon AS, Bajwa RP, Russo TA. Hypervirulent (hypermucoviscous) Klebsiella pneumoniae: a new and dangerous breed. Virulence 2013;4:107-118.   DOI
3 Wong CH, Kurup A, Wang YS, Heng KS, Tan KC. Four cases of necrotizing fasciitis caused by Klebsiella species. Eur J Clin Microbiol Infect Dis 2004;23:403-407.   DOI   ScienceOn
4 Keynan Y, Rubinstein E. The changing face of Klebsiella pneumoniae infections in the community. Int J Antimicrob Agents 2007;30:385-389.   DOI   ScienceOn
5 Fang CT, Lai SY, Yi WC, Hsueh PR, Liu KL. The function of wzy_K1 (magA), the serotype K1 polymerase gene in Klebsiella pneumoniae cps gene cluster. J Infect Dis 2010; 201:1268-1269.   DOI   ScienceOn
6 Yu WL, Ko WC, Cheng KC, et al. Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan. Clin Infect Dis 2006; 42:1351-1358.   DOI   ScienceOn
7 Jung SW, Chae HJ, Park YJ, et al. Microbiological and clinical characteristics of bacteraemia caused by the hypermucoviscosity phenotype of Klebsiella pneumoniae in Korea. Epidemiol Infect 2013;141:334-340.   DOI
8 Braiteh F, Golden MP. Cryptogenic invasive Klebsiella pneumoniae liver abscess syndrome. Int J Infect Dis 2007;11:16-22.   DOI   ScienceOn
9 Cheng NC, Yu YC, Tai HC, et al. Recent trend of necrotizing fasciitis in Taiwan: focus on monomicrobial Klebsiella pneumoniae necrotizing fasciitis. Clin Infect Dis 2012;55:930-939.   DOI   ScienceOn
10 Persichino J, Tran R, Sutjita M, Kim D. Klebsiella pneumoniae necrotizing fasciitis in a Latin American male. J Med Microbiol 2012;61(Pt 11):1614-1616.   DOI   ScienceOn