Fatal neck necrotizing fasciitis caused by hypermucoviscous Klebsiella pneumoniae

Abstract

Klebsiella pneumoniae is a gram-negative rod enterobacteria that is notorious for its role as carrier of extended spectrum beta-lactamase (ESBL) and its carbapenem resistant Enterobacteriaceae (CRE) species. However, hypermucoviscous Klebsiella pneumoniae is distinctly different from ESBL and CRE. We report a case of neck necrotizing fasciitis caused by hypermucoviscous Klebsiella pneumoniae in a 56-year-old male who presented to our emergency department (ED) with a swollen neck. His condition deteriorated rapidly requiring emergency intubation to secure his airway. Despite aggressive resuscitation and treatment with broad spectrum antibiotics and cytokine adsorption therapy, the patient succumbed to his disease. This report describes the clinical characteristics of hypermucoviscous Klebsiella pneumoniae and emphasizes the importance of early detection and subsequent aggressive source control interventions in necrotizing fascitiis caused by this particular bacteria.

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