Peculiar purulence: Hypervirulent Klebsiella pneumoniae causing pyomyositis

• Type of Material: Article
• Authors: Okechukwu Mgbemena, Providence Hospital of North Houston; David P. Serota, Emory University; Sonali Kumar, Emory University; Jessie E. Wozniak, Emory University; David Weiss, Emory University; Russell Kempker, Emory University
• Language: English
• Date: 2017-12-01
• Publisher: Elsevier: Creative Commons Attribution Non-Commercial No-Derivatives License
• Publication Version: Final Published Version
• Copyright Statement: © 2017 The Author(s)
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ijid.2017.09.030
• Title of Journal or Parent Work: International Journal of Infectious Diseases
• ISSN: 1201-9712
• Volume: 65
• Start Page: 90
• End Page: 92
• Grant/Funding Information: DSW is supported by a Burroughs Wellcome Fund Investigator in the Pathogenesis of Infectious Disease award. RRK is supported in part by the National Institutes of Allergy and Infectious Diseases Award (K23AI103044).
• Keywords: Science & Technology; Klebsiella; VIRULENCE; Virulence; Gastrocnemius; Life Sciences & Biomedicine; LIVER-ABSCESS; Pyomyositis; Infectious Diseases
• Research Categories: Health Sciences, Public Health; Health Sciences, Immunology

Abstract

This report describes the first confirmed case of isolated pyomyositis caused by a hypervirulent strain of Klebsiella pneumoniae. Pyomyositis is almost universally caused by gram-positive organisms and while the recent emergence of invasive disease due to hypervirulent K. pneumoniae has been well documented, the most common clinical manifestation reported is liver abscess. The K. pneumoniae isolate in our case had a hypermucousviscous phenotype as demonstrated by a positive string test and was confirmed to be hypervirulent with molecular testing. Documenting the extrahepatic manifestations of hypervirulent Klebsiella pneumoniae strains is important to increase clinical awareness and in guiding empiric antibiotic regimens.