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Fulminant pseudomembranous enterocolitis caused by Klebsiella oxytoca: an autopsy case report
Tatsunori Nagamura1, Yoshihiro Tanaka1, Takero Terayama1
1Department of Traumatology and Critical Care Medicine National Defense Medical College Saitama Japan.
Case:
We describe a rare case of antibiotic-associated fulminant pseudomembranous enterocolitis caused by Klebsiella oxytoca. A 79-year-old man with a history of antibiotic therapy was admitted to our emergency department, complaining of consciousness disturbance. Initially, we suspected septic shock and diabetic ketoacidosis caused by intestinal infection. Although we administered sufficient extracellular fluid, his blood pressure was not elevated and his abdomen gradually swelled.
Outcome:
The patient died of shock and abdominal compartment syndrome. Autopsy revealed widespread jejunal necrosis in conjunction with colitis, suggesting fulminant pseudomembranous enterocolitis caused by K. oxytoca infection.
Conclusion:
As the clinical features of pseudomembranous enterocolitis caused by K. oxytoca resemble the features of colitis caused by Clostridium difficile, conservative therapy is applied first. However, fulminant pseudomembranous enterocolitis is a lethal disease, necessitating early operation for resection of the necrotic lesion. This report highlights the need for better surgical criteria at an early stage.
Insights
Fulminant pseudomembranous enterocolitis caused by Klebsiella oxytoca is a rare but lethal condition. Early surgical intervention is crucial for survival, despite initial conservative treatment approaches.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Critical Care Medicine
Background:
- Antibiotic-associated pseudomembranous enterocolitis is typically linked to Clostridium difficile.
- Klebsiella oxytoca is an uncommon cause of this severe intestinal condition.
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