Klebsiella invasive syndrome: a challenging diagnosis

• Published in: BMJ case reports 2022-11, Vol.15 (11), p.e251977
• Main Authors: Bhide, Poorva Prashant, Ketkar, Apurva Avadhut, Almeligy, Abdalrahman, Ricca, Anthony
• Format: Article
• Language: English
• Subjects: Antibiotics; Bacterial infections; Case reports; Case Reports: Rare disease; Delayed Diagnosis; Female; Gram-negative bacteria; Humans; Klebsiella; Klebsiella Infections - diagnosis; Klebsiella Infections - drug therapy; Klebsiella pneumoniae; Liver Abscess - diagnostic imaging; Liver Abscess - pathology; Medical diagnosis; Syndrome
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2022-251977

Klebsiella invasive syndrome is a rare condition that typically presents as a liver abscess with metastatic infection, with mortality rates as high as 14% potentially due to diagnostic delay by clinicians. Here, we present a case of a woman in her 60s, who presented with symptoms and signs consistent with meningitis, imaging findings suggestive of possible leptomeningeal carcinomatosis a long with areas of lung consolidation and abdominal nodules and lymphadenopathy, presumably metastatic malignancy. We diagnosed Klebsiella invasive syndrome and treated it conservatively with medical management, including a long course of intravenous antibiotic therapy and supportive care. This is an infrequently encountered clinical entity with potentially fatal consequences, and we hope to add to the existing literature on the subject and drive home the point that it should be considered in the differential diagnoses in the appropriate clinical scenario.