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

• Published in: BMC infectious diseases Vol. 24; no. 1; pp. 820 - 6
• Main Authors: Li, Runjun, Liu, Junlong, Yang, Liye, Lin, Zhiwei, Rong, Ling, Chen, Gang, Tang, Xiuying
• Format: Journal Article
• Language: English
• Published: England BioMed Central 13.08.2024; BMC
• Subjects: Abscesses; Aged; Anti-Bacterial Agents - therapeutic use; Antibiotics; Bacteremia; Bacteria; Bacterial infections; beta-Lactamases - metabolism; Blood; Case Report; Cough; Drug resistance; Dyspnea; Epididymis; Epididymitis; Epididymitis - drug therapy; Epididymitis - microbiology; Extended-spectrum β-lactamase; Fever; Hospitals; Humans; Hypervirulence; Infections; Intensive care; Intubation; Klebsiella; Klebsiella Infections - drug therapy; Klebsiella Infections - microbiology; Klebsiella pneumonia; Klebsiella pneumonia invasion syndrome; Klebsiella pneumoniae; Klebsiella pneumoniae - pathogenicity; Laboratories; Lung Abscess - drug therapy; Lung Abscess - microbiology; Lungs; Lymphatic system; Male; Medical imaging; Metastasis; Neutrophils; Oxygen saturation; Patients; Pleural effusion; Pneumonia; Pulmonary abscess; Respiration; Ultrasonic imaging; Virulence; β Lactamase; Klebsiella pneumonia; Klebsiella pneumonia invasion syndrome; Epididymitis; Extended-spectrum β-lactamase; Hypervirulence; Pulmonary abscess
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-024-09721-2

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. 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. 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.