Openly accessible

Bilateral osteomyelitis and liver abscess caused by hypervirulent Klebsiella pneumoniae- a rare clinical manifestation (case report)

Sturm, Emma, Tai, Alex, Lin, Belinda, Kwong, Jason, Athan, Eugene, Howden, Benjamin P, Angliss, Richard D, Asaid, Rafik and Pollard, James 2018, Bilateral osteomyelitis and liver abscess caused by hypervirulent Klebsiella pneumoniae- a rare clinical manifestation (case report), BMC infectious diseases, vol. 18, pp. 1-5, doi: 10.1186/s12879-018-3277-4.

Attached Files
Name Description MIMEType Size Downloads
athan-bilateralosteomyelitis-2018.pdf Published version application/pdf 994.42KB 1

Title Bilateral osteomyelitis and liver abscess caused by hypervirulent Klebsiella pneumoniae- a rare clinical manifestation (case report)
Formatted title Bilateral osteomyelitis and liver abscess caused by hypervirulent Klebsiella pneumoniae- a rare clinical manifestation (case report)
Author(s) Sturm, Emma
Tai, Alex
Lin, Belinda
Kwong, Jason
Athan, EugeneORCID iD for Athan, Eugene orcid.org/0000-0001-9838-6471
Howden, Benjamin P
Angliss, Richard D
Asaid, Rafik
Pollard, JamesORCID iD for Pollard, James orcid.org/0000-0001-9984-2870
Journal name BMC infectious diseases
Volume number 18
Article ID 380
Start page 1
End page 5
Total pages 5
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2018-08-07
ISSN 1471-2334
1471-2334
Keyword(s) Klebsiella pneumoniae
hypervirulent
osteomyelitis
pyogenic liver abscess
science & technology
life sciences & biomedicine
infectious diseases
Summary BACKGROUND: Hypervirulent strains of Klebsiella pneumoniae are a recognized cause of a distinct invasive syndrome that results in pyogenic liver abscesses and metastatic complications, particularly in the Asia Pacific region. Reports of hypervirulent K.pneumoniae in Europe, the Americas and Australia indicate worldwide spread. We present a case of multi-focal osteomyelitis, a rarely described complication of hypervirulent K.pneumoniae in the medical literature. The prevalence of this condition in countries outside Asia may be expected to rise with increasing travel.

CASE PRESENTATION: A 20-year-old Chinese man residing in Australia for 2 years presented with a 2-week history of gradually worsening leg pain preceded by 2 weeks of constitutional symptoms. Imaging with computerized axial tomography (CT) and other modalities revealed bilateral tibial lesions described as lattice-like linear lucencies involving the cortices with scalloping of the outer involved cortex. Cultures of tissue from a left tibial bone biopsy were positive cultures for K.pneumoniae. Whole-genome sequencing identified the isolate as K1 serotype ST23, a well-recognized hyper virulent strain capable of causing invasive disease. An abdominal CT revealed a 27x22mm liver abscess. The patient had no other metastatic manifestations of the disease, and responded to 6 weeks of intravenous ceftriaxone followed by 3 months of oral Ciprofloxacin.

CONCLUSIONS: Increased awareness of the manifestations and subsequent management of hyper virulent strains of K.pneumoniae by clinicians is important to assist early recognition and help minimize serious sequelae. Cases with overseas links, such as previous residence in the Asia Pacific area, are at higher risk for infection with the hyper virulent strain. This case highlights the need for clinicians to be able to recognize this important disease, especially in patients with the right epidemiological links, and to investigate and treat appropriately to prevent severe metastatic complications.
Language eng
DOI 10.1186/s12879-018-3277-4
Field of Research 0605 Microbiology
1103 Clinical Sciences
1108 Medical Microbiology
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2018, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30114230

Document type: Journal Article
Collections: School of Medicine
Open Access Collection
Connect to link resolver
 
Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved.

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.

Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 0 times in TR Web of Science
Scopus Citation Count Cited 0 times in Scopus
Google Scholar Search Google Scholar
Access Statistics: 10 Abstract Views, 3 File Downloads  -  Detailed Statistics
Created: Thu, 11 Oct 2018, 13:47:31 EST

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.