title: Two cases of pyomyositis caused by Klebsiella pneumoniae and review of the literature.
abstract: Two patients with diabetes mellitus developed Klebsiella pneumoniae pyomyositis involving multiple muscles and other metastatic foci associated with bacteraemia. The cases are presented here, and the 22 cases of gram-negative pyomyositis reported previously in the literature are reviewed. As gram-positive cocci cause 99% of pyomyositis, it is postulated that the pathogenesis of pyomyositis may be associated with the ability of the bacteria to adhere to muscles by various cell surface adhesins that are not present in gram-negative bacilli. It is also postulated that a high serum glucose concentration may facilitate the growth and formation of the Klebsiella pneumoniae capsule, hence increasing its virulence and causing serious disseminated Klebsiella infections in diabetic patients.
authors.affiliation: Department of Microbiology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: T K
authors.initials: TK
authors.lastname: Wang
authors.forename: S S
authors.initials: SS
authors.lastname: Wong
authors.forename: P C
authors.initials: PC
authors.lastname: Woo
mesh_terms: D000328:Adult; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D009220:Myositis / Q000382:microbiology*