Annals of Emergency Medicine
Volume 53, Issue 5 , Pages 639-642 , May 2009

Invasive Infection With Hypermucoviscous Klebsiella pneumoniae: Multiple Cases Presenting to a Single Emergency Department in the United States

  • Bradley W. Frazee, MD

      Affiliations

    • Department of Emergency Medicine, Alameda County Medical Center–Highland Campus, Oakland, CA
    • Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA
    • Corresponding Author InformationAddress for reprints: Bradley W. Frazee, MD, Department of Emergency Medicine, Alameda County Medical Center-Highland Campus, Oakland, CA 94602; 510-437-8323, fax 510-437-8322
    • ,
  • Shandi Hansen, MD

      Affiliations

    • Department of Emergency Medicine, Alameda County Medical Center–Highland Campus, Oakland, CA
    • ,
  • Larry Lambert, MPH

      Affiliations

    • Department of Emergency Medicine, Alameda County Medical Center–Highland Campus, Oakland, CA

Received 19 September 2008 ,Revised 7 November 2008 ,Accepted 12 November 2008.

References 

  1. Cheng DL, Liu YC, Yen MY, et al. Septic metastatic lesions of pyogenic liver abscess (Their association with Klebsiella pneumoniae bacteremia in diabetic patients). Arch Intern Med. 1991;151:1557–1559
  2. Wang JH, Liu YC, Lee SS, et al. Primary liver abscess due to Klebsiella pneumoniae in Taiwan. Clin Infect Dis. 1998;26:1434–1438
  3. Ko WC, Paterson DL, Sagnimeni AJ, et al. Community-acquired Klebsiella pneumoniae bacteremia: global differences in clinical patterns. Emerg Infect Dis. 2002;8:160–166
  4. Kawai T. Hypermucoviscosity: an extremely sticky phenotype of Klebsiella pneumoniae associated with emerging destructive tissue abscess syndrome. Clin Infect Dis. 2006;42:1359–1361
  5. Yu VL, Hansen DS, Ko WC, et al. Virulence characteristics of Klebsiella and clinical manifestations of K. pneumoniae bloodstream infections. Emerg Infect Dis. 2007;13:986–993
  6. Fang CT, Chuang YP, Shun CT, et al. A novel virulence gene in Klebsiella pneumoniae strains causing primary liver abscess and septic metastatic complications. J Exp Med. 2004;199:697–705
  7. Yu WL, Ko WC, Cheng KC, et al. Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan. Clin Infect Dis. 2006;42:1351–1358
  8. Rahimian J, Wilson T, Oram V, et al. Pyogenic liver abscess: recent trends in etiology and mortality. Clin Infect Dis. 2004;39:1654–1659
  9. Lederman ER, Crum NF. Pyogenic liver abscess with a focus on Klebsiella pneumoniae as a primary pathogen: an emerging disease with unique clinical characteristics. Am J Gastroenterol. 2005;100:322–331
  10. Nadasy KA, Domiati-Saad R, Tribble MA. Invasive Klebsiella pneumoniae syndrome in North America. Clin Infect Dis. 2007;45:e25–e28
  11. Fang FC, Sandler N, Libby SJ. Liver abscess caused by magA+ Klebsiella pneumoniae in North America. J Clin Microbiol. 2005;43:991–992
  12. Talan DA, Moran GJ, Mower WR, et al. EMERGEncy ID NET: an emergency department-based emerging infections sentinel network (The EMERGEncy ID NET Study Group). Ann Emerg Med. 1998;32:703–711
  13. Goodwin T, Noji E. Syndromic surveillance. Eur J Emerg Med. 2004;11:1–2
  14. Moran GJ, Krishnadasan A, Gorwitz RJ, et al. Methicillin-resistant S. aureus infections among patients in the emergency department. N Engl J Med. 2006;355:666–674
  15. Infectious Disease Society of America. EIN Reports Cases of Hyperviscous Klebsiella pneumoniae With Liver Abscesses (IDSA News). Vol 18 In: Arlington, VA: Infectious Disease Society of America; 2008;p. 1
  16. Hui JY, Yang MK, Cho DH, et al. Pyogenic liver abscesses caused by Klebsiella pneumoniae: US appearance and aspiration findings. Radiology. 2007;242:769–776

 Supervising editor: Gregory J. Moran, MD

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement.

 Publication date: Available online January 8, 2009.

PII: S0196-0644(08)02007-6

doi: 10.1016/j.annemergmed.2008.11.007

Annals of Emergency Medicine
Volume 53, Issue 5 , Pages 639-642 , May 2009

Article Tools

* Image Usage & Resolution