Hypervirulent Klebsiella pneumoniae에 의한 괴사근막염과요근 농양
Necrotizing fasciitis and psoas abscess caused by hypervirulent Klebsiella pneumoniae
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초록
Hypervirulent K. pneumoniae (hvKP)는 아시아에서 침습성 감염을 일으키는 주요 원인균으로 주로 원발성 간농양과 전이성 감염을 일으킨다. 괴사근막염은 드물게 발생하는 hvKP의 감염증상으로, 빠르고 심한 질환의 경과를 보이므로 적절한 항생제와 빠른 수술적 치료가 환자의 예후에 중요하다. 저자들은 당뇨 환자에서 상처를 통해서 침입한 hypermucoviscous phenotype을 가진 hvKP에 의해 발생한 괴사근막염과 요근 농양을 국내에서 처음으로 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
A 62-year-old diabetic female was admitted to the hospital with fever and pain in both legs. Computed tomography scans of the abdomen revealed necrotizing fasciitis of the right thigh extending into the abdominal wall, and abscesses on the right psoas muscle. Magnetic resonance imaging showed increased T2 signal intensity along the peroneus muscle and fascia of the lower left leg. The patient received antibiotics and underwent debridement of the infected and necrotic tissue. Intra-abdominal abscesses were drained. Blood and pus cultures showed growth of Klebsiella pneumoniae, as had been suspected due to string test results showing hypermucoviscosity. Free-skin grafts were performed to repair tissue loss and the patient was subsequently discharged 82 days after admission. This represents the first reported case of necrotizing fasciitis and psoas muscle abscess caused by a hypervirulent strain of K. pneumoniae in Korea.
참고문헌 (10)
- Fang CT, "A novel virulence gene in Klebsiella pneumoniae strains causing primary liver abscess and septic metastatic complications", J Exp Med, 199, pp.697~705 (2004)
- Shon AS, "Hypervirulent(hypermucoviscous)Klebsiella pneumoniae : a new and dangerous breed", Virulence, 4, pp.107~118 (2013)
- Wong CH, "Four cases of necrotizing fasciitis caused by Klebsiella species", Eur J Clin Microbiol Infect Dis, 23, pp.403~407 (2004)
- Keynan Y, "The changing face of Klebsiella pneumoniae infections in the community", Int J Antimicrob Agents, 30, pp.385~389 (2007)
- Fang CT, "The function of wzy_K1 (magA), the serotype K1 polymerase gene in Klebsiella pneumoniae cps gene cluster", J Infect Dis, 201, pp.1268~1269 (2010)
- Yu WL, "Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan", Clin Infect Dis, 42, pp.1351~1358 (2006)
- Jung SW, "Microbiological and clinical characteristics of bacteraemia caused by the hypermucoviscosity phenotype of Klebsiella pneumoniae in Korea", Epidemiol Infect, 141, pp.334~340 (2013)
- Braiteh F, "Cryptogenic invasive Klebsiella pneumoniae liver abscess syndrome", Int J Infect Dis, 11, pp.16~22 (2007)
- Cheng NC, "Recent trend of necrotizing fasciitis in Taiwan : focus on monomicrobial Klebsiella pneumoniae necrotizing fasciitis", Clin Infect Dis, 55, pp.930~939 (2012)
- Persichino J, "Klebsiella pneumoniae necrotizing fasciitis in a Latin American male", J Med Microbiol, 61(11), pp.1614~1616 (2012)