[Lung abscess due to community acquired Klebsiella pneumonia].
BACKGROUND
In western countries, community-acquired pneumonias due to Klebsiella pneumoniae (Kp) are rare and associated with a poor prognosis and a high mortality. The severity is in part linked to the virulence of Kp. Immuno-depression, sepsis and visceral abscesses are frequently found, constituting other classical risk factors for severity and contributing to the poor prognosis. The therapeutic strategy is based on third generation cephalosporins, aminoglycosides and quinolones.


METHODS
We report the case of a young adult, with undiagnosed diabetes, hospitalized as an emergency for septic shock complicating a community-acquired pneumonia due to Kp and associated with multiple brain and lung abscesses. After several weeks of treatment, initially with empirical then specific antibiotics, a favourable outcome was obtained.


CONCLUSIONS
This case report underlines the particular severity of infections due to Kp and their main pathophysiological mechanisms. It is also an opportunity to highlight the potential responsibility of Kp in the presence of a pneumonia with lung abscesses and finally to update the principles of antibiotic therapy.
Baudrand
H
H
Service de Pneumologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, et Université Claude Bernard, Lyon, France.
Mbatchou Ngahane
B H
BH
Marcu
M
M
Freymond
N
N
Pacheco
Y
Y
Devouassoux
G
G
D000583:Amikacin / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001922:Brain Abscess / Q000188:drug therapy / Q000209:etiology; D017714:Community-Acquired Infections; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D007710:Klebsiella Infections / Q000150:complications* / Q000188:drug therapy; D007711:Klebsiella pneumoniae; D008169:Lung Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010878:Piperacillin / Q000008:administration & dosage / Q000627:therapeutic use; D013902:Radiography, Thoracic; D012772:Shock, Septic / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000583:Amikacin; D010878:Piperacillin