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Hypermucoviscous Klebsiella pneumoniae: A Hypervirulent Strain Masquerading as Metastasis
Mulham Ombada1, Talha Perwez2, Marco Campitelli3
1Internal Medicine, State University of New York Upstate Medical University, Syracuse, USA.
Abstract:
Hypermucoviscous Klebsiella pneumoniae (HvKP) is a hypervirulent strain of Klebsiella that causes metastatic spread and life-threatening infection. While it is more common among people of Asian descent, it has been increasingly reported globally among people of other ethnicities as well. We report a case of pan-susceptible HvKP infection in a male patient of Asian descent who has been living in the US for 20 years. It caused a liver abscess, perigastric abscess, perisplenic abscess, multifocal pneumonia, septic emboli, and tricuspid valve infective endocarditis. He was treated with ceftriaxone, but his septic shock was refractory, ultimately leading to death. This case highlights the severity of infection caused by this strain, and its ability to present with radiographic signs suggestive of malignancy with metastasis. This case also suggests that this strain can become pathogenic after a very prolonged period of gastrointestinal colonization.
Insights
Hypermucoviscous Klebsiella pneumoniae (HvKP) can cause severe, life-threatening infections with metastatic spread. This case highlights HvKP
Area of Science:
- Infectious Diseases
- Microbiology
- Pathogenesis
Background:
- Hypermucoviscous Klebsiella pneumoniae (HvKP) is a hypervirulent bacterial strain known for causing severe, life-threatening infections with metastatic potential.
- While historically more prevalent in individuals of Asian descent, HvKP infections are increasingly reported globally across diverse ethnicities.
Observation:
- A case of pan-susceptible HvKP infection is presented in a male patient of Asian descent residing in the US.
- The infection manifested as a liver abscess, perigastric abscess, perisplenic abscess, multifocal pneumonia, septic emboli, and tricuspid valve infective endocarditis.
- The patient experienced refractory septic shock despite ceftriaxone treatment, ultimately leading to mortality.
Findings:
- HvKP infection can present with radiographic findings mimicking malignancy and metastatic disease.
- This strain may remain pathogenic after extended periods of gastrointestinal colonization.
- The case underscores the aggressive nature and potential for widespread dissemination of HvKP.
Implications:
- Highlights the critical need for early recognition and aggressive management of HvKP infections, regardless of patient ethnicity or duration of colonization.
- Emphasizes the diagnostic challenge posed by HvKP, which can be mistaken for metastatic cancer.
- Suggests further research into the long-term pathogenic potential of gastrointestinal colonization by HvKP.
