Infection and Drug Resistance (Oct 2024)
Otitis Media Progressing to Community-Acquired Meningitis in Diabetic Patients: A Case Report of K2-ST375 hypervirulent Klebsiella pneumoniae and Literature Review
Abstract
Shanshan Jin,1,2,* Hui Xie,1,* Ruilan Wang1,2 1Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, 200080, People’s Republic of China; 2Department of Critical Care Medicine, Shanghai General Hospital of Nanjing Medical University, Shanghai, 200080, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ruilan Wang, Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, 200080, People’s Republic of China, Email [email protected]: Community-acquired Klebsiella pneumoniae meningitis (CA-KPM) can rapidly progress to invasive infection in healthy individuals. We present the case of a 54-year-old man with a history of acute suppurative otitis media and uncontrolled type 2 diabetes mellitus (T2DM), who had been treated with oral antibiotics intermittently and irregularly for one month. His symptoms did not improve and continued to worsen, leading to fever and coma. Metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) identified Klebsiella pneumoniae (KP) after 24 hours in the intensive care unit (ICU). Subsequent CSF culture confirmed a hypervirulent KP (hvKp) strain with capsular genotype K2 and sequence type (ST) 375. Fortunately, the patient made a full recovery with targeted antimicrobial therapy and was discharged. Despite the delayed diagnosis, the outcome was favorable. This case highlights the importance of clinicians, particularly otolaryngologists, maintaining a high index of suspicion for CA-KPM in patients with both otitis media and T2DM, emphasizing the need for timely multidisciplinary consultation.Keywords: Klebsiella pneumoniae, hypervirulent, case report, meningitis, community-acquired
