title: Septic arthritis subsequent to urosepsis caused by hypermucoviscous Klebsiella pneumoniae.
abstract: We herein report the first case of septic arthritis caused by rmpA-positive hypermucoviscous community-acquired K. pneumoniae that followed urosepsis in a 65-year-old Japanese woman. The patient responded well to drainage of the abscesses and treatment with cefazolin. Although this virulent phenotype of K. pneumoniae has been primarily reported in Hong Kong, we confirmed that 18/50 isolates obtained in our hospital over the past five years displayed the hypermucoviscous phenotype. Therefore, clinicians should consider the possibility of an increasing prevalence of rmpA-positive hypermucoviscous K. pneumoniae infection in Japan and be particularly vigilant for invasive clinical manifestations, even in patients with urinary tract infections.
authors.affiliation: Department of Hematology and Oncology, Mie University Graduate School of Medicine, Japan. keis@clin.medic.mie-u.ac.jp
authors.forename: Kei
authors.initials: K
authors.lastname: Suzuki
authors.forename: Akiko
authors.initials: A
authors.lastname: Nakamura
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Enokiya
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Iwashita
authors.forename: Eri
authors.initials: E
authors.lastname: Tomatsu
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Muraki
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kaneko
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okuda
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Katayama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imai
mesh_terms: D000368:Aged; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D014552:Urinary Tract Infections / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology