Klebsiella pneumoniae meningitis in a 38-year-old Chinese traveller with impaired glucose tolerance: a new emerging syndrome?
Klebsiella pneumoniae meningitis in a 38-year-old Chinese traveller with impaired glucose tolerance: a new emerging syndrome?
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DOI：
10.1016/j.tmaid.2007.10.008
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发表时间：
2008-01-01
影响因子：
12
通讯作者：
Caramello, Pietro
中科院分区：
文献类型：
--
作者：
Boglione, Lucio;Spezia, Claudia;Caramello, Pietro
细菌性脑膜炎的早期诊断和适当的经验性治疗可降低发病率和死亡率。与细菌性脑膜炎相关的不同病原体的患病率取决于年龄、基础医疗状况、感染方式和地理分布。肺炎克雷伯氏菌是东南亚和东北亚社区获得性脑膜炎的罕见病因，占所有细菌性脑膜炎的20%，通常与脓毒性转移性并发症相关。我们描述了一个案例K。一例新移民糖耐量减低患者并发肺炎性脑膜炎、复视和球结膜水肿。K.在台湾和东南亚，肺炎的流行情况尚不清楚：在该地区，血清型K1和K2的高流行率以及称为magA的新基因座的表达已被提出，该基因座赋予细菌升高的吞噬抗性和活跃的增殖能力。在来自中国大陆和台湾的移民中，必须高度怀疑这种病因。细菌性脑膜炎具有很高的致死率，因此在管理细菌性脑膜炎时应考虑经验性治疗指南，患者的地理来源和临床症状（脑膜炎和眼内炎）是K的潜在危险因素。肺炎感染。
Early diagnosis and appropriate empirical treatment of bacterial meningitis reduce morbidity and mortality. Prevalence rates of different causative pathogens associated with bacterial meningitis can depend on age, the underlying medical condition, way of infection and geographical distribution. Klebsiella pneumoniae represents an infrequent cause of community-acquired meningitis in South-East Asia and North-East Asia, where it accounts for 20% of all bacterial meningitis, frequently associated with septic metastatic complications. We describe a case of K. pneumoniae meningitis, diplopia and chemosis in a recently immigrated patient with impaired glucose tolerance. The reason for the high prevalence of metastatic septic infections caused by K. pneumoniae in Taiwan and South-East Asia remains unclear: high prevalence in this area of serotype K1 and K2 and the expression of a novel locus called magA conferring to bacterium an elevated phagocytosis resistance and an active proliferation ability have been suggested. A high degree of suspicion for this etiology must be taken into account in immigrants from China and Taiwan. Due to a very high lethality, guidelines on empiric treatment should be considered in the management of bacterial meningitis, with the patients geographical origin and the clinical syndrome (meningitis and endophtalmitis) as potential risk factors for K. pneumoniae infection.