Beyond classical Klebsiella pneumoniae: invasive hypervirulent Klebsiella pneumoniae infection. A case report and literature review

Abstract

Hypervirulent Klebsiella pneumoniae (hvKp) is an emerging pathotype associated with bacteremia with hematogenous dissemination and deep-seated abscess formation. Data from Chile, remain scarce. We report the case of a previously healthy 40-year-old man presenting with a febrile syndrome consistent with a complicated urinary tract infection, Microbiological testing confirmed K. pneumoniae bacteremia. Imaging studies revealed urinary-prostatic involvement with multiple collections, a hepatic abscess, bilateral cavitary pulmonary nodules and septic thrombosis of the splanchnic venous system. Microbiological characterization identified a hypermucoviscous phenotype and the presence of hypervirulence-associated genes (iucA, iroB, rmpA2) was confirmed. Treatment with third-generation cephalosporins was administered, with a favorable clinical evolution, without the need for surgical drainage, and allowing completion of outpatient antimicrobial therapy. This case highlights the importance to suspect hvKp in severe infections with multifocal involvement, and of active microbiological surveillance in our environment.