Septic Meningitis and Liver Abscess due to Hypermucoviscous Klebsiella pneumoniae Complicated with Chronic Strongyloidiasis in a Human T-lymphotropic Virus 1 Carrier

Intern Med. 2020 Jan 1;59(1):129-133. doi: 10.2169/internalmedicine.3403-19. Epub 2019 Aug 21.

Abstract

Recently, severe cases of infection due to hypermucoviscous Klebsiella pneumonia (hmKP) have been reported in Japan. The Amami Islands in Japan are also endemic regions for Strongyloides stercoralis. Disseminated strongyloidiasis strain often causes severe enterobacteria infection; however, whether or not chronic strongyloidiasis induces it remains unclear. We herein report a 71-year-old man who developed meningitis and liver abscess due to hmKP complicated with chronic strongyloidiasis. He died on the seventh hospital day. Strongyloides stercoralis were only found around the polyp in the cecum. Chronic strongyloidiasis can also induce severe infection due to enterobacteria, especially hypervirulent pathogens like hmKP, through the induction of mucosal rupture.

Keywords: hypermucoviscous Klebsiella pneumoniae; liver abscess; meningitis; strongyloidiasis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Alcoholism / complications
  • Chronic Disease
  • Fatal Outcome
  • HTLV-I Infections / complications*
  • Hepatitis B, Chronic / complications
  • Human T-lymphotropic virus 1
  • Humans
  • Japan
  • Klebsiella Infections / complications*
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / microbiology
  • Klebsiella pneumoniae
  • Liver Abscess / complications*
  • Male
  • Meningoencephalitis / complications*
  • Strongyloidiasis / complications*
  • Strongyloidiasis / diagnosis
  • Strongyloidiasis / drug therapy