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Case Reports
. 2022 Mar 16;10(8):2610-2615.
doi: 10.12998/wjcc.v10.i8.2610.

Fatal systemic emphysematous infection caused by Klebsiella pneumoniae: A case report

Jun-Qiang Zhang  1 , Chan-Chan He  1 , Bo Yuan  1 , Rui Liu  1 , Yu-Jing Qi  1 , Zi-Xia Wang  1 , Xiao-Na He  1 , Yu-Min Li  2
Affiliations
Case Reports

Fatal systemic emphysematous infection caused by Klebsiella pneumoniae: A case report

Jun-Qiang Zhang et al. World J Clin Cases. .

Abstract

Background: Systemic emphysematous infection caused by Klebsiella pneumoniae (K. pneumo niae) is a rare but severe infection which can be lethal if the diagnosis is delayed.

Case summary: We report a rare case of systemic emphysematous infection via hematogenous dissemination from a liver abscess caused by K. pneumoniae, complicated by multiple organ dysfunction syndrome, septic shock, bacteremia, emphysematous cystitis, prostate and left seminal vesicle abscesses in a diabetic patient. The patient simultaneously presented with spontaneous pneumoperitoneum secondary to rupture of the emphysematous liver abscess. His condition after admission deteriorated rapidly and he died within a short period. This disease is a great challenge for the clinician as K. pneumoniae can cause multifocal emphysematous infections and fulminant septic shock. Pneumoperitoneum following spontaneous rupture of the liver abscess can result in intra-abdominal sepsis that further increases mortality rate. Moreover, appropriate site-specific intervention and adequate drainage of numerous emphysematous liver lesions are difficult.

Conclusion: Early diagnosis followed by efficient antibiotic therapy and surgical management are essential for systemic emphysematous infection.

Keywords: Emphysematous cystitis; Emphysematous liver abscess; Emphysematous prostate abscess; Klebsiella pneumoniae; Pneumoperitoneum; Septic shock.

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Conflict of interest statement

Conflict-of-interest statement: All authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Abdominal computed tomography scan shows multiple emphysematous hepatic abscesses. A and B: Arrowheads represent gas formation in the right subphrenic area; A-E: Thin arrows represent gas-containing liver abscess cavities; F: Thick arrows represent ruptured liver abscesses.
Figure 2
Figure 2
Pelvic computed tomography scan shows emphysematous cystitis, prostate and seminal vesicle abscesses. A: Thin arrow represents intramural gas formation in the bladder, and arrowhead represents emphysematous seminal vesicle abscesses; B: Thick arrows represent abnormal air accumulation in the enlarged prostate.
See this image and copyright information in PMC

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