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Occult community acquired Klebsiella pneumoniae purulent meningitis in an adult: A case report

RATIONALE: Klebsiella pneumonia (K. pneumonia), primarily a hospital-acquired pathogen, can cause a variety of deep-seated infections with significant morbidities. However, in the current scenario of global rise in antibiotic abuse, unexpected infection could be caused by K. pneumoniae. PATIENT CONC...

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Autores principales: Yang, Kai-Chuang, Shrestha, Tejashwi, Kolakshyapati, Manish, Shi, Ling-Fei, Wang, Zheng, Li, Min, Lou, Lin, Zhou, Jia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024475/
https://www.ncbi.nlm.nih.gov/pubmed/29923989
http://dx.doi.org/10.1097/MD.0000000000011017
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author Yang, Kai-Chuang
Shrestha, Tejashwi
Kolakshyapati, Manish
Shi, Ling-Fei
Wang, Zheng
Li, Min
Lou, Lin
Zhou, Jia
author_facet Yang, Kai-Chuang
Shrestha, Tejashwi
Kolakshyapati, Manish
Shi, Ling-Fei
Wang, Zheng
Li, Min
Lou, Lin
Zhou, Jia
author_sort Yang, Kai-Chuang
collection PubMed
description RATIONALE: Klebsiella pneumonia (K. pneumonia), primarily a hospital-acquired pathogen, can cause a variety of deep-seated infections with significant morbidities. However, in the current scenario of global rise in antibiotic abuse, unexpected infection could be caused by K. pneumoniae. PATIENT CONCERNS: A 56-year-old male who presented with intermittent headache and low fever was admitted, he had transsphenoidal surgery for pituitary adenoma 3 years ago. Routine laboratory tests revealed an elevated WBC count of 10.12 × 10(9)/L and C-reactive protein (CRP) 12.9 mg/L. computed tomography (CT) revealed the sellar region with suspicious hemorrhage. DIAGNOSES: The patient was initially diagnosed with acute residual tumor hemorrhage. But the consequent diagnose of Klebsiella pneumoniae purulent meningitis was made based on the cerebrospinal fluid lab test and cerebrospinal fluid (CSF) and blood culture, and CT scan. INTERVENTIONS: Lumbar puncture examination was made and the antibiotics were adjusted to meropenem and vancomycin according to the antibiotic sensitivity test. But because of the patient's unstable vital signs, his family refuse further lateral ventricular drainage. OUTCOMES: The infection was out of control and the patient died of spontaneous breath and heartbeat arrest. LESSONS: Through this case, we could learn that any clue of suspicious intracranial infection should be carefully considered in the current scenario of global rise in antibiotic abuse. The manifestation of intermittent headache and mild fever could be potential signs of fatal infection, and prompt appropriate measures should be taken timely.
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spelling pubmed-60244752018-07-03 Occult community acquired Klebsiella pneumoniae purulent meningitis in an adult: A case report Yang, Kai-Chuang Shrestha, Tejashwi Kolakshyapati, Manish Shi, Ling-Fei Wang, Zheng Li, Min Lou, Lin Zhou, Jia Medicine (Baltimore) Research Article RATIONALE: Klebsiella pneumonia (K. pneumonia), primarily a hospital-acquired pathogen, can cause a variety of deep-seated infections with significant morbidities. However, in the current scenario of global rise in antibiotic abuse, unexpected infection could be caused by K. pneumoniae. PATIENT CONCERNS: A 56-year-old male who presented with intermittent headache and low fever was admitted, he had transsphenoidal surgery for pituitary adenoma 3 years ago. Routine laboratory tests revealed an elevated WBC count of 10.12 × 10(9)/L and C-reactive protein (CRP) 12.9 mg/L. computed tomography (CT) revealed the sellar region with suspicious hemorrhage. DIAGNOSES: The patient was initially diagnosed with acute residual tumor hemorrhage. But the consequent diagnose of Klebsiella pneumoniae purulent meningitis was made based on the cerebrospinal fluid lab test and cerebrospinal fluid (CSF) and blood culture, and CT scan. INTERVENTIONS: Lumbar puncture examination was made and the antibiotics were adjusted to meropenem and vancomycin according to the antibiotic sensitivity test. But because of the patient's unstable vital signs, his family refuse further lateral ventricular drainage. OUTCOMES: The infection was out of control and the patient died of spontaneous breath and heartbeat arrest. LESSONS: Through this case, we could learn that any clue of suspicious intracranial infection should be carefully considered in the current scenario of global rise in antibiotic abuse. The manifestation of intermittent headache and mild fever could be potential signs of fatal infection, and prompt appropriate measures should be taken timely. Wolters Kluwer Health 2018-06-22 /pmc/articles/PMC6024475/ /pubmed/29923989 http://dx.doi.org/10.1097/MD.0000000000011017 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle Research Article
Yang, Kai-Chuang
Shrestha, Tejashwi
Kolakshyapati, Manish
Shi, Ling-Fei
Wang, Zheng
Li, Min
Lou, Lin
Zhou, Jia
Occult community acquired Klebsiella pneumoniae purulent meningitis in an adult: A case report
title Occult community acquired Klebsiella pneumoniae purulent meningitis in an adult: A case report
title_full Occult community acquired Klebsiella pneumoniae purulent meningitis in an adult: A case report
title_fullStr Occult community acquired Klebsiella pneumoniae purulent meningitis in an adult: A case report
title_full_unstemmed Occult community acquired Klebsiella pneumoniae purulent meningitis in an adult: A case report
title_short Occult community acquired Klebsiella pneumoniae purulent meningitis in an adult: A case report
title_sort occult community acquired klebsiella pneumoniae purulent meningitis in an adult: a case report
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024475/
https://www.ncbi.nlm.nih.gov/pubmed/29923989
http://dx.doi.org/10.1097/MD.0000000000011017
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