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

BACKGROUND: Systemic emphysematous infection caused by Klebsiella pneumoniae (K. pneumoniae) 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.