PDF(Pubmed)
Abstract：
A 42-year-old man was admitted to the emergency room complaining of fever and headache. His cerebrospinal fluid showed a cloudy appearance, and his white blood cell count was elevated at 2460/mm3, with a predominance of neutrophils (81%), and abnormal protein and glucose levels (510.7 mg/dL and 5 mg/dL, respectively). A lobulated lesion with rim enhancement, suggestive of abscess, was detected through magnetic resonance imaging. Klebsiella pneumoniae was detected in nasopharyngeal swab and blood cultures. The capsular serotype of K. pneumoniae was K2 and the sequence type determined by multilocus sequence typing was 23. The hypervirulent phenotype was associated with multiple virulent genes, including rmpA, rmpA2, entB, ybtS, kfu, iucA, iutA, iroB mrkD, allS, peg-344, peg-589, and peg-1631. After six weeks of receiving appropriate antibiotics and exhibiting clinical resolution of the brain abscesses, the patient was discharged. We present the first reported case of a healthy community-dwelling adult with solitary brain abscesses, and no other invasive abscesses, related to hypervirulent K. pneumoniae.
摘要：
一名42岁的男子因发烧和头痛而被送往急诊室。他的脑脊液显示浑浊，他的白细胞计数升高到2460/mm3，主要是中性粒细胞（81％），以及异常的蛋白质和葡萄糖水平（510.7mg/dL和5mg/dL，分别)。叶状病变边缘增强，暗示着脓肿，是通过磁共振成像检测到的。在鼻咽拭子和血培养物中检测到肺炎克雷伯菌。肺炎克雷伯菌的荚膜血清型为K2，通过多位点序列分型确定的序列类型为23。高毒力表型与多个毒力基因有关，包括RMPA,rmpA2,entB,ybtS,kfu,iuca,IutA,iroBmrkD,allS,peg-344，peg-589和peg-1631。在接受适当的抗生素并表现出脑脓肿的临床消退六周后，病人出院了。我们介绍了第一例报告的健康社区居住的成年人患有孤立的脑脓肿，也没有其他侵袭性脓肿,与高毒力肺炎克雷伯菌有关。
