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Klebsiella brain abscess in adults
1Dept of Neurosurgery and Neurology, Chang Gung Memorial Hospital, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan.
Background:
We analyzed the clinical manifestations and therapeutic outcomes of Klebsiella brain abscesses.
Patients And Methods:
The clinical data of 15 patients with Klebsiella brain abscesses, retrospectively collected over a 14-year period, were studied.
Results:
The 15 patients included 13 cases of Klebsiella pneumoniae infection and two cases of Klebsiella oxytoca. All but one case were community-acquired infections. Locations of all of these abscesses were supratentorial. 12 cases involved a single abscess, and three involved multiple abscesses. Gas formation was also found in two cases (13%). Common predisposing factors included metastatic spread, chronic otitis media and neurosurgical procedures. Among these 15 patients, 11 were treated surgically and four received antibiotics alone. In total, 11 patients survived and four died, with an overall mortality rate of 26.7%.
Conclusion:
The clinical presentations and therapeutic outcomes varied according to the different Klebsiella species. While debilitating diseases were common in K. pneumoniae infections, they were not common in K. oxytoca infection. And while metastatic septic abscess is a well-known, devastating complication of K. pneumoniae septicemia, usually seen as a brain abscess with a gas-forming appearance, all of these K. oxytoca infections had both otogenic infections and more favorable outcomes.
Insights
Clinical outcomes for Klebsiella brain abscesses varied by species. Klebsiella pneumoniae infections were more severe than Klebsiella oxytoca, highlighting species-specific treatment considerations for brain abscesses.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiology
Background:
- Klebsiella species are a significant cause of brain abscesses.
- Understanding clinical manifestations and treatment outcomes is crucial for patient management.
Observation:
- A 14-year retrospective study analyzed 15 patients with Klebsiella brain abscesses.
- Klebsiella pneumoniae (13 cases) and Klebsiella oxytoca (2 cases) were identified.
- Most infections were community-acquired, supratentorial, and often associated with predisposing factors like metastasis or otitis media.
Findings:
- Surgical treatment was employed in 11 patients, while four received antibiotics alone.
- The overall mortality rate was 26.7% (4 deaths).
- Klebsiella pneumoniae infections presented with more severe, debilitating diseases and gas formation, whereas Klebsiella oxytoca infections were linked to otogenic sources and better outcomes.
Implications:
- Clinical presentation and outcomes differ significantly between Klebsiella pneumoniae and Klebsiella oxytoca brain abscesses.
- Tailoring treatment strategies based on the specific Klebsiella species may improve patient outcomes.
- Further research into species-specific virulence factors and therapeutic responses is warranted.