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Case Reports
. 2024 Aug 13;24(1):820.
doi: 10.1186/s12879-024-09721-2.

Pulmonary abscess secondary to epididymitis caused by extended spectrum β-lactamase-producing hypervirulent Klebsiella pneumoniae: a case report

Runjun Li  1 , Junlong Liu  1 , Liye Yang  2 , Zhiwei Lin  3 , Ling Rong  4 , Gang Chen  5 , Xiuying Tang  6
Affiliations
Case Reports

Pulmonary abscess secondary to epididymitis caused by extended spectrum β-lactamase-producing hypervirulent Klebsiella pneumoniae: a case report

Runjun Li et al. BMC Infect Dis. .

Abstract

Background: Pulmonary abscesses resulting from epididymitis caused by extended spectrum β-lactamase-producing hypervirulent Klebsiella pneumoniae (ESBL-hvKp) in a nondiabetic patient are extremely uncommon. The infection caused by this disseminated drug-resistant bacteria, which is generally considered an intractable case, poses a potential challenge in clinical practice.

Case presentation: In this case report, we present the clinical course of a 71-year-old male patient with epididymitis, who subsequently developed cough and dyspnea following anti-infection treatment. Imaging examinations revealed severe pneumonia and pulmonary abscess. The infection of ESBL-hvKp in the epididymis led to bacteremia and subsequent lung lesions. Due to poor response to anti-infection therapy, the patient required an extended duration of anti-infection treatment and ultimately chosed to discontinue treatment.

Conclusions: Acute epididymitis caused by ESBL-hvKP infection can result in the spread of the infection through the bloodstream, leading to severe pneumonia and lung abscess. Given the critical condition of the patient, even with active anti-infection treatment, there is a risk of treatment failure or potentially fatal outcomes.

Keywords: Klebsiella pneumonia; Klebsiella pneumonia invasion syndrome; Epididymitis; Extended-spectrum β-lactamase; Hypervirulence; Pulmonary abscess.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Scrotal Ultrasound. The right epididymis associated with an enlargement in size and vascularization (blue and red signal)
Fig. 2
Fig. 2
Chest X-ray. (A) Scattered bilateral patchy ground-glass opacity and pulmonary nodules with some cystic cavities, and small left-sided pleural effusion; (B) more bilateral patchy ground-glass opacity and small left-sided pleural effusion; (C)extensive bilateral patchy ground-glass opacity with multiple pulmonary cavities, and small bilateral pleural effusion
Fig. 3
Fig. 3
Computed tomography (CT) scan of the chest. (A, B) Bilateral pulmonary nodules with central cavitation representing pulmonary abscesses; (C, D) multiple pulmonary nodules with central cavitation; (E, F) numerous large cavitary lesions representing multifocal pulmonary abscesses
See this image and copyright information in PMC

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