Severe Klebsiella pneumoniae pneumonia complicated by acute intra-abdominal multiple arterial thrombosis and bacterial embolism:A case report  

作　　者：Xiao-Li Bao Nan Tang Yang-Zhong Wang 

机构地区：[1]Department of Respiratory and Critical Care Medicine,Chongqing University Fuling Hospital,Chongqing 408000,China

出　　处：《World Journal of Clinical Cases》2022年第30期11101-11110,共10页世界临床病例杂志

基　　金：Supported by the Chongqing Regional Key Discipline Construction Project,No.zdxk201702。

摘　　要：BACKGROUND Klebsiella pneumoniae(K.pneumoniae)is a clinically common Gram-negative bacillus that can cause community-and hospital-acquired infections and lead to pneumonia,liver abscesses,bloodstream infections,and other infectious diseases;however,severe pneumonia caused by hypervirulent K.pneumoniae(hv Kp)complicated by acute intra-abdominal multiple arterial thrombosis and bacterial embolism is rarely seen in the clinical setting and has not been reported in the literature.CASE SUMMARY A 51-year-old man was hospitalized with fever and dyspnea.Persistent mild pain in the middle and upper abdomen began at dawn on the 3rd day following admission and developed into persistent severe pain in the left upper abdomen 8h later.Based on chest computed tomography(CT),bronchoscopy,bronchoalveolar lavage fluid metagenomic next-generation sequencing,abdominal aortic CT angiography(CTA),and culture of the superior mesenteric artery embolus,adult community-acquired severe hv Kp pneumonia complicated by acute intraabdominal multiple arterial thrombosis and bacterial embolism was diagnosed.Notably,he recovered and was discharged from the hospital after receiving effective meropenem anti-infection,endovascular contact thrombolytic,and systemic anticoagulant therapies and undergoing percutaneous thrombus aspiration.Ten days later,the patient returned to the hospital for abdominal CTA examination,which indicated blocked initial common pathway of the celiac trunk and superior mesenteric artery,and local stenosis.Therefore,celiac trunk artery stenting was performed in Chongqing Hospital,and postoperative recovery was good.CONCLUSION We report a case of hv Kp severe pneumonia complicated by acute intra-abdominal multiple arterial thrombosis and bacterial embolism and suggest that clinicians should consider the possibility of a Gram-negative bacillus infection and conduct effective pathogen detection in a timely fashion when managing patients with severe community-acquired pneumonia before obtaining bacteriologic and drug sensitivity

关 键 词：Klebsiella pneumoniae Severe pneumonia Acute mesenteric ischemia Superior mesenteric artery embolism Case report 

分 类 号：R563.1[医药卫生—呼吸系统]