Abstract
We report a case of a 49-year-old male with a history of chronic alcoholism and evidence of a pancreatic pseudocyst on CT scanning. He presented with a 3-days history of fever, loss of appetite and upper abdominal pain. Blood cultures grew Klebsiella pneumoniae and he improved clinically with a seven-day course of intravenous co-amoxiclav and metronidazole. Two weeks later he was readmitted to hospital with impaired consciousness and septic shock, and died three days later in intensive care. Post mortem examination revealed bacterial meningitis and an infected pancreatic pseudocyst. Klebsiella pneumoniae was isolated from the pancreas and meninges.
Highlights
A 49-year-old man was admitted to hospital with a three day history of fever, loss of appetite and upper abdominal pain
Bacterial meningitis caused by K. pneumoniae is uncommon but some cases have been reported, especially in Taiwan
Over a four-year period, 27 Taiwanese patients were diagnosed with K. pneumoniae meningitis[1] and in another Taiwanese case series conducted over six years, the proportion of K. pneumoniae as a cause of bacterial meningitis rose from 8% to 18%[2]
Summary
Like other members of the family enterobacteriaceae, K pneumoniae causes infection of bile and urine, sterile fluids in close proximity with the gastrointestinal tract. Bacterial meningitis caused by K. pneumoniae is uncommon but some cases have been reported, especially in Taiwan. Outside Taiwan, cases of K. pneumoniae meningitis have occurred, predominantly in other parts of Asia [5,6,7] and in Europe [8,9,10,11] and North America [12,13,14]. The rarity of these cases outside Asia raises the possibility of ethnicity or country of origin predisposing individuals to invasive disease[15]. Infection occurs in approximately 10% of cases[19] and this is an indication for drainage which can be achieved endoscopically or at open surgery
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