Invasive Klebsiella syndrome in a case in Bolivia

Abstract

Klebsiella pneumoniae is a Gram-negative bacterium that requires oxygen and is capable of fermenting lactose. It can cause serious infections such as pneumonia, bacteremia, and liver abscesses. There are two main subtypes: the classic strain (cKP) and the hypervirulent strain (hvKP), the latter being identified by its highly viscous mucus phenotype and its remarkable ability to invade.
The most common hvKP lineage is ST23-K1, although K2 lineages (ST65, ST86, ST66) have also been recognized in different parts of the world, including South America. hvKP can affect healthy individuals and those with additional diseases, with diabetes mellitus being a relevant risk factor due to its association with immune dysfunction and hyperglycemia, conditions that favor bacterial growth and spread through the circulatory system. The case presented concerns a 45-year-old diabetic woman who was admitted with severe diabetic ketoacidosis and pneumonia caused by Klebsiella pneumoniae. Despite intensive treatment that included antibiotics and respiratory support, the patient developed multiple lung abscesses and a possible septic embolism, dying after 18 days in intensive care unit.