Giuseppe
Emeritus
[Source: The Lancet Infectious Diseases, full text: (LINK). Abstract, edited.]
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The Lancet Infectious Diseases, Volume 12, Issue 11, Pages 881 - 887, November 2012
doi:10.1016/S1473-3099(12)70205-0
Klebsiella pneumoniae liver abscess: a new invasive syndrome
Original Text
L Kristopher Siu PhD a b, Kuo-Ming Yeh MD c, Jung-Chung Lin MD c, Chang-Phone Fung MD e, Dr Feng-Yee Chang MD c d
Summary
Klebsiella pneumoniae is a well known human nosocomial pathogen. Most community-acquired K pneumoniae infections cause pneumonia or urinary tract infections. During the past two decades, however, a distinct invasive syndrome that causes liver abscesses has been increasingly reported in Asia, and this syndrome is emerging as a global disease. In this Review, we summarise the clinical presentation and management as well the microbiological aspects of this invasive disease. Diabetes mellitus and two specific capsular types in the bacterium predispose a patient to the development of liver abscesses and the following metastatic complications: bacteraemia, meningitis, endophthalmitis, and necrotising fasciitis. For patients with this invasive syndrome, appropriate antimicrobial treatment combined with percutaneous drainage of liver abscesses increases their chances of survival. Rapid detection of the hypervirulent strain that causes this syndrome allows earlier diagnosis and treatment, thus minimising the occurrence of sequelae and improving clinical outcomes.
a Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan; b Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan; c Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Centre, Taipei, Taiwan; d Taiwan Centres for Disease Control, Taipei, Taiwan; e Section of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
Correspondence to: Dr Feng-Yee Chang, Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Centre, Cheng-Kung Road, Taipei 114, Taiwan
-doi:10.1016/S1473-3099(12)70205-0
Klebsiella pneumoniae liver abscess: a new invasive syndrome
Original Text
L Kristopher Siu PhD a b, Kuo-Ming Yeh MD c, Jung-Chung Lin MD c, Chang-Phone Fung MD e, Dr Feng-Yee Chang MD c d
Summary
Klebsiella pneumoniae is a well known human nosocomial pathogen. Most community-acquired K pneumoniae infections cause pneumonia or urinary tract infections. During the past two decades, however, a distinct invasive syndrome that causes liver abscesses has been increasingly reported in Asia, and this syndrome is emerging as a global disease. In this Review, we summarise the clinical presentation and management as well the microbiological aspects of this invasive disease. Diabetes mellitus and two specific capsular types in the bacterium predispose a patient to the development of liver abscesses and the following metastatic complications: bacteraemia, meningitis, endophthalmitis, and necrotising fasciitis. For patients with this invasive syndrome, appropriate antimicrobial treatment combined with percutaneous drainage of liver abscesses increases their chances of survival. Rapid detection of the hypervirulent strain that causes this syndrome allows earlier diagnosis and treatment, thus minimising the occurrence of sequelae and improving clinical outcomes.
a Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan; b Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan; c Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Centre, Taipei, Taiwan; d Taiwan Centres for Disease Control, Taipei, Taiwan; e Section of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
Correspondence to: Dr Feng-Yee Chang, Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Centre, Cheng-Kung Road, Taipei 114, Taiwan
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