Perianal Abscess and Proctitis by Klebsiella pneumoniae

Area of Science:

• Infectious Diseases
• Gastroenterology
• Microbiology

Background:

• Klebsiella pneumoniae (K. pneumoniae) can cause severe invasive infections, particularly in immunocompromised individuals.
• Patients with diabetes mellitus and a history of alcohol abuse are at higher risk for invasive K. pneumoniae infections.
• Proctitis and perianal abscess are rare manifestations of invasive K. pneumoniae.

Purpose of the Study:

• To report the first documented case of proctitis and perianal abscess caused by invasive K. pneumoniae.
• To highlight the aggressive nature of K. pneumoniae infections in at-risk populations.
• To emphasize the importance of early diagnosis and appropriate management.

Main Methods:

• A case report of a 61-year-old male patient with diabetes and alcohol abuse presenting with abdominal and anal pain.
• Diagnostic procedures included sigmoidoscopy, abdominal CT, and rectal MRI.
• Microbiological analysis of pus culture identified extended-spectrum beta-lactamase-producing K. pneumoniae.

Main Results:

• Sigmoidoscopy revealed severe rectal and sigmoid colon ulcerations, which worsened despite initial antibiotic treatment.
• Imaging confirmed a perianal and perirectal abscess.
• The patient required laparoscopic sigmoid colostomy and abscess drainage, with subsequent improvement after switching to ertapenem.

Conclusions:

• Invasive K. pneumoniae can lead to rapid and severe proctitis and perianal abscess formation.
• Patients with diabetes and alcohol abuse are particularly vulnerable to such invasive infections.
• Multimodal treatment including surgery and appropriate antibiotics is essential for successful outcomes.