Klebsiella pneumoniae cervical necrotizing fasciitis originating as an abscess.
Cervical necrotizing fasciitis is a rapidly progressive and devastating infection that is usually caused by a polymicrobial infection including group A Streptococcus and anaerobes. We present a case of a newly diagnosed diabetic man who underwent transoral drainage of a Klebsiella pneumoniae paraglottic abscess, which, despite culture-directed antibiotics, progressed to cervical necrotizing fasciitis with descending mediastinitis. The patient required 12 surgical debridements and sternotomy, but survived and was discharged on hospital day 40. To our knowledge, this is the first case of cervical necrotizing fasciitis caused by a K pneumoniae infection in the United States. The significance of this unusual presentation is discussed.
Department of Otolaryngology-Head and Neck Surgery, Harborview Medical Center, Seattle, WA, USA. andrewjt@uw.edu
Andrew J
AJ
Thomas
Sandy
S
Mong
Justin S
JS
Golub
Tanya K
TK
Meyer
D000038:Abscess / Q000209:etiology* / Q000382:microbiology / Q000628:therapy; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003646:Debridement / Q000379:methods; D019115:Fasciitis, Necrotizing / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D006801:Humans; D007710:Klebsiella Infections / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D007711:Klebsiella pneumoniae / Q000472:pathogenicity*; D008297:Male; D009333:Neck
D000900:Anti-Bacterial Agents