Peculiar purulence: Hypervirulent Klebsiella pneumoniae causing pyomyositis

• 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
• Journal Title: International Journal of Infectious Diseases
• Volume: Volume 65
• Publisher: Elsevier: Creative Commons Attribution Non-Commercial No-Derivatives License | 2017-12-01, Pages 90-92
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1016/j.ijid.2017.09.030
• Subjects: Health Sciences, Immunology; Health Sciences, Public Health
• Keywords: Science & Technology; Life Sciences & Biomedicine; Infectious Diseases; Klebsiella; Pyomyositis; Gastrocnemius; Virulence; LIVER-ABSCESS; VIRULENCE

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.