Clinical Features of Bullous and Pustular in Systemic Klebsiella Pneumoniae Infection in Immunocompetent Patients
Keywords:
Klebsiella pneumoniae, bullous and pustular generalized, infectionAbstract
K. pneumoniae is a rare cause of systemic infection but can lead to high mortality and poor prognosis in immunocompromised patients. However, reports of skin manifestations that occurrences in immunocompetent patients are rare. We are reported here A 33-year-old female presented with red patches accompanied by papules and blisters all over her body for one week, with previous complaints of fever and productive cough. Dermatological examination revealed multiple generalized pustules and bullae. Positive Nikolsky sign and Asboe-Hansen sign were observed. Blood and wound culture confirmed the presence of K. pneumoniae. The bullae regressed rapidly within five days after antibiotic therapy. The purpose of this case report is to enhance knowledge about cases of K. pneumoniae infection presenting clinically as generalized bullous and pustular lesions. Clinicians should consider systemic K. pneumoniae infection when evaluating patients with generalized bullous and pustular lesions.References
Ashurst J V, Dawson A. Pneumonia, Klebsiella. New York: StatPearls Publishing; 2018.
Elenitsas R, Chu EY. Pathology of Skin Lesions. In: Fitzpatrick"s Dermatology. 9th ed. New York: Mc Graw Hill Education; 2019. p. 18–39. [online] Avai-lable: accessmedicine.mhmedical.com/content.aspx?aid=1161320385.
Huang HY, Wu YH, Kuo CF. Klebsiella Pneumo-niae Sepsis with Unusual Cutaneous Presentation of Generalized Pustulosis. Clin Exp Dermatol. 2013;38(6):626–9. doi: 10.1111/ced.12092.
Holt KE, Wertheim H, Zadoks RN, Baker S, Whi-tehouse CA, Dance D, et al. Genomic Analysis of Diversity, Population Structure, Virulence, And Antimicrobial Resistance In Klebsiella Pneumo-niae, An Urgent Threat To Public Health. Proc Natl Acad Sci. 2015;112(27):E3574–81.
Doi: 10.1073/pnas.1501049112
Li B, Zhao Y, Liu C, Chen Z, Zhou D. Molecular Pathogenesis of Klebsiella Pneumoniae. Future Microbiol. 2014;9(9):1071–81.
Doi: 10.2217/fmb.14.48.
Li S, Yu S, Peng M, Qin J, Xu C, Qian J, et al. Cli-nical Features and Development Of Sepsis In Kleb-siella Pneumoniae Infected Liver Abscess Patients: A Retrospective Analysis of 135 Cases. BMC Infect Dis. 2021;21(1):1–11.
Doi: 10.1186/s12879-021-06325-y.
Chang D, Sharma L, Dela Cruz CS, Zhang D. Cli-nical Epidemiology, Risk Factors, and Control Strategies Of Klebsiella Pneumoniae Infection. Front Microbiol. 2021;12(1):1–9.
Doi: 10.3389/fmicb.2021.750662.
Zakanito M, Saputro ID. Klebsiella Pneumoniae Necrotizing Fascitis of The Lower Extremity in A 7-Month-Old Male: A Case Report and. J Rekon-struksi Estet. 2019;4(2):52–7.
Doi: 10.20473/jre.v4i2.28220.
de Villa AR, Charles K, Okonoboh P. A Rare Case of Purpura Fulminans in the Setting of Klebsiella pneumoniae Bacteremia. Cureus. 2022;14(3):1–6.
Doi: 10.7759/cureus.22921.
Sawano T, Tsubokura M, Leppold C, Ozaki A, Fujioka S, Nemoto T, et al. Klebsiella Pneumoniae Sepsis Deteriorated by Uncontrolled Underlying Disease in a Decontamination Worker in Fukushi-ma, Japan. J Occup Health. 2016;58(3):320–2.
Doi: 10.1539/JOH.15-0292-CS.
Paczosa MK, Mecsas J. Klebsiella pneumoniae: Going on the Offense with a Strong Defense. Micr-obiol Mol Biol Rev. 2016;80(3):629–61.
Doi: 10.1128/MMBR.00078-15.
Lee CR, Lee JH, Park KS, Jeon JH, Kim YB, Cha CJ, et al. Antimicrobial Resistance of Hypervirulent Klebsiella pneumoniae: Epidemiology, Hyperviru-lence-Associated Determinants, and Resistance Mechanisms. Front Cell Infect Microbiol. 2017;7(1): 1–13. Doi: 10.3389/fcimb.2017.00483.