title: Intensive care management of community-acquired Klebsiella pneumoniae.
abstract: The clinical features of 18 patients with Klebsiella pneumoniae requiring intensive care unit (ICU) management are presented. All patients required ventilatory support; 17 were given constant positive pressure ventilation and 10 required greater than 10 cm positive end expiratory pressure. The clinical picture was characteristic: pre-existing medical disease, clinical features of severe pneumonia and copious purulent bronchial secretions, Gram--ve organisms on Gram's stain and lobar consolidation on the chest radiograph were common. Septicaemic shock, confusion and uncompensated metabolic acidosis were the presenting clinical features predicting a poor outcome. Antimicrobial chemotherapy, that combined an aminoglycoside and a third generation cephalosporin to ensure adequate early antibiotic serum levels, may help to improve the prognosis.
authors.affiliation: Department of Anaesthetics, Medicine and Medical Microbiology, University of Cape Town, Observatory, RSA.
authors.forename: J M
authors.initials: JM
authors.lastname: Hammond
authors.forename: P D
authors.initials: PD
authors.lastname: Potgieter
authors.forename: D M
authors.initials: DM
authors.lastname: Linton
authors.forename: A A
authors.initials: AA
authors.lastname: Forder
mesh_terms: D000138:Acidosis / Q000209:etiology; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003422:Critical Care; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D007711:Klebsiella pneumoniae; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000628:therapy*; D011175:Positive-Pressure Respiration; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D012772:Shock, Septic / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents