title: Pediatric hypervirulent Klebsiella pneumoniae septic arthritis.
abstract: Cases of infection with hypervirulent Klebsiella pneumoniae are gradually increasing in number, and cause life-threatening community-acquired infection even in immunocompetent patients. A 14-year-old boy developed septic hip arthritis due to hypervirulent K. pneumoniae (sequence type 23, serotype K1, magA positive). The patient initially seemed to have been successfully treated with antibiotics and surgical intervention, but septic arthritis developed into osteomyelitis of the femoral head and myositis, which required long-term antibiotic therapy and additional surgical intervention. This is the first pediatric case of hypervirulent K. pneumoniae septic hip arthritis. Treatment plans should mainly consist of antibiotic therapy and surgical intervention. Clinicians, even pediatricians, in developed countries should be aware of the increasing incidence of hypervirulent Klebsiella pneumoniae infection.
authors.affiliation: Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Shun
authors.initials: S
authors.lastname: Kishibe
authors.affiliation: Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.|Department of Quantitative Methods, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Okubo
authors.affiliation: Division of Infectious Disease, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Saeko
authors.initials: S
authors.lastname: Morino
authors.affiliation: Division of Infectious Disease, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Hirotaki
authors.affiliation: Division of Laboratory, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Tame
authors.affiliation: Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Aoki
authors.affiliation: Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ishii
authors.affiliation: Division of Orthopedics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Norikazu
authors.initials: N
authors.lastname: Ota
authors.affiliation: Division of Orthopedics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shimomura
authors.affiliation: Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sakakibara
authors.affiliation: Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Terakawa
authors.affiliation: Division of Infectious Disease, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Yuho
authors.initials: Y
authors.lastname: Horikoshi
keywords: bacterial translocation; hypermucoviscosity; hypervirulent Klebsiella pneumoniae; septic arthritis; string test