Acute Crit Care.  2021 Nov;36(4):390-394. 10.4266/acc.2021.00010.

The first case of abdominal mycotic aneurysm caused by K1 hypervirulent Klebsiella pneumoniae in a healthy adult

• Kim M
• Yoo JR
• Oh H
• Kim YR
• Lee KH
• Heo ST

• KMID: 2524324
• DOI: http://doi.org/10.4266/acc.2021.00010

Abstract

Incidence of hypervirulent Klebsiella pneumoniae (hvKp) infection has been steadily increasing in the Asia-Pacific rim. The characteristic of hvKp infection is its ability to cause multiple site infections and unpredictable metastatic spread in the community. We describe the first case of mycotic aneurysm caused by hvKp serotype K1 in a previously healthy man and review the literature. Of a total of 13 cases, including our case, three cases were related to hvKp. Among patients with hvKp, the level of mycotic aneurysm in most patients was the infrarenal aorta, and they underwent an aortic graft or coil embolization. All strains were susceptible to most antimicrobial agents, except ampicillin. Early detection of hvKp can help to prevent the metastatic spread of pathogens and be useful for optimal patient care and epidemiologic research.

Keyword

hypervirulent; liver abscess; metastatic infection; mycotic aneurysm

Figure

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  Figure 1. (A) Low-density lesion in the liver (black arrow) and (B) new aneurysmal dilatation with thrombosis, wall enhancement, and periarterial fatty infiltration in left common iliac artery (white arrow) are observed using enhanced abdominal computed tomography.

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  Figure 2. String test is used to confirm the hypermucoviscosity of Klebsiella pneumoniae isolates recovered from the blood culture. A positive result was defined as the formation of a viscous rope of length >5 mm when a bacterial colony was touched with a loop on the agar plate.

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