First Italian report of a liver abscess and metastatic endogenous endophthalmitis caused by ST-23 hypervirulent Klebsiella pneumoniae in an immunocompetent individual.


Journal

Infection
ISSN: 1439-0973
Titre abrégé: Infection
Pays: Germany
ID NLM: 0365307

Informations de publication

Date de publication:
Feb 2023
Historique:
received: 18 03 2022
accepted: 21 06 2022
pubmed: 9 7 2022
medline: 31 1 2023
entrez: 8 7 2022
Statut: ppublish

Résumé

Klebsiella pneumoniae is a common species in the gut of mammals and is widely distributed in the environment. However, the environmental source of hvKp that precedes gut colonization is unclear, but once that it reaches the gut there is a possible generalized spread y fecal-oral transmission especially in endemic areas. Liver abscess might develop when the bacteria, using its virulence factors, cross the intestinal barrier and invade the liver by the portal circulation. This syndrome, prevalent mostly in Asian countries, is increasingly reported in Western Countries and leaves open questions about the source of infection. Here we describe for the first time in Italy, a case of pyogenic liver abscess caused by a hypervirulent Klebsiella pneumoniae (HvKp) complicated by endophthalmitis and other metastatic infections in lung and prostate in an immunocompetent Chinese healthy individual with no recent travel in Asia. This case underlines the need for increased awareness of hypervirulent K. pneumoniae, even in settings where it occurs infrequently and where there are not evident epidemiological links.

Sections du résumé

BACKGROUND BACKGROUND
Klebsiella pneumoniae is a common species in the gut of mammals and is widely distributed in the environment. However, the environmental source of hvKp that precedes gut colonization is unclear, but once that it reaches the gut there is a possible generalized spread y fecal-oral transmission especially in endemic areas. Liver abscess might develop when the bacteria, using its virulence factors, cross the intestinal barrier and invade the liver by the portal circulation. This syndrome, prevalent mostly in Asian countries, is increasingly reported in Western Countries and leaves open questions about the source of infection.
CASE METHODS
Here we describe for the first time in Italy, a case of pyogenic liver abscess caused by a hypervirulent Klebsiella pneumoniae (HvKp) complicated by endophthalmitis and other metastatic infections in lung and prostate in an immunocompetent Chinese healthy individual with no recent travel in Asia.
CONCLUSION CONCLUSIONS
This case underlines the need for increased awareness of hypervirulent K. pneumoniae, even in settings where it occurs infrequently and where there are not evident epidemiological links.

Identifiants

pubmed: 35802342
doi: 10.1007/s15010-022-01879-8
pii: 10.1007/s15010-022-01879-8
pmc: PMC9879799
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

271-276

Informations de copyright

© 2022. The Author(s).

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Auteurs

Maria A De Francesco (MA)

Institute of Microbiology, Department of Molecular and Translational Medicine, University of Brescia-ASST Spedali Civili, P. Le Spedali Civili, 1, 125123, Brescia, Italy. maria.defrancesco@unibs.it.

Giorgio Tiecco (G)

Division of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili, Brescia, Italy.

Erika Scaltriti (E)

Institute of Microbiology, Department of Molecular and Translational Medicine, University of Brescia-ASST Spedali Civili, P. Le Spedali Civili, 1, 125123, Brescia, Italy.
Risk Analysis and Genomic Epidemiology Unit, Istituto Zooprofilattico Sperimentale Della Lombardia E Dell'Emilia Romagna, Parma, Italy.

Giorgio Piccinelli (G)

Institute of Microbiology, Department of Molecular and Translational Medicine, University of Brescia-ASST Spedali Civili, P. Le Spedali Civili, 1, 125123, Brescia, Italy.

Silvia Corbellini (S)

Institute of Microbiology, Department of Molecular and Translational Medicine, University of Brescia-ASST Spedali Civili, P. Le Spedali Civili, 1, 125123, Brescia, Italy.

Francesca Gurrieri (F)

Institute of Microbiology, Department of Molecular and Translational Medicine, University of Brescia-ASST Spedali Civili, P. Le Spedali Civili, 1, 125123, Brescia, Italy.

Verena Crosato (V)

Division of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili, Brescia, Italy.

Giovanni Moioli (G)

Division of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili, Brescia, Italy.

Valentina Marchese (V)

Division of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili, Brescia, Italy.

Emanuele Focà (E)

Division of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili, Brescia, Italy.

Davide A Bertelli (DA)

Division of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili, Brescia, Italy.

Francesco Castelli (F)

Division of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili, Brescia, Italy.

Arnaldo Caruso (A)

Institute of Microbiology, Department of Molecular and Translational Medicine, University of Brescia-ASST Spedali Civili, P. Le Spedali Civili, 1, 125123, Brescia, Italy.

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Classifications MeSH