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Annals of Vascular Surgery

Volume 24, Issue 5, July 2010, Pages 693.e11-693.e14
Annals of Vascular Surgery

Case Report Abstract
Termination of a 4-month Serial Klebsiella pneumoniae Septicemia in a Diabetic Woman After Aneurysmectomy in Conjunction With Antimicrobial Therapy

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A diabetic woman suffered from deep neck infection, endophthalmitis, urinary tract infection, and mycotic aneurysm associated Klebsiella pneumoniae bacteremia for 4 months. Aneurysmectomy and antibiotic therapy terminated recurrent K pneumoniae sepsis suggestive of removal of the pathogen niche in an artery, which served as the root of serial infections. The DNA fingerprints of K pneumoniae isolates indicated that the same strain K pneumoniae caused all the infection episodes. The case is reported and its clinical implications are discussed.

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Case Report

A 68-year-old woman was first hospitalized with the chief complaint of the emergence of a painful neck mass on the right 3 days before. She had an underlying diabetes mellitus and was being treated with oral hypoglycemic agents. Computed tomography (CT) demonstrated a ring-enhanced lesion over her right inferior sternocleidomastoid muscle, indicating an abscess. After drawing blood for culture, cefazolin was used coupled with incision and drainage of the abscess. Blood and abscess cultures both

Dicussion

K pneumoniae is notorious for causing complicated infections such as liver abscess, endophthalmitis, meningitis, lung abscess, and mycotic aneurysm in diabetic patients.1, 2, 3, 4, 5, 6, 7, 8, 11, 12, 13 Why diabetic patients are so vulnerable to K pneumoniae has not been fully understood, although these patients are known to have impaired chemotaxis and phagocytosis of neutrophils.13, 14, 15 Primary liver abscess caused by K pneumoniae has long been an important infectious complications in

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