1. Fulminant pseudomembranous enterocolitis caused by Klebsiella oxytoca: an autopsy case report
- Author
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Yoshihiro Tanaka, Yuya Yoshimura, Naoaki Isoi, Takero Terayama, Shinji Akitomi, Daizoh Saitoh, Yuka Katsurada, Kimiya Sato, Hitoshi Tsuda, Tatsunori Nagamura, Hisashi Ikeuchi, Soichiro Seno, Daishi Higashiyama, Yasumasa Sekine, and Akiko Matsubara
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Abdominal compartment syndrome ,Diabetic ketoacidosis ,Fulminant ,Case Report ,Case Reports ,Gastroenterology ,Inflammatory bowel disease ,03 medical and health sciences ,0302 clinical medicine ,inflammatory bowel disease ,Internal medicine ,medicine ,Colitis ,biology ,Septic shock ,business.industry ,General Engineering ,Klebsiella oxytoca ,Clostridium difficile ,medicine.disease ,biology.organism_classification ,030104 developmental biology ,septic shock ,business ,030217 neurology & neurosurgery - Abstract
Case We describe a rare case of antibiotic-associated fulminant pseudomembranous enterocolitis caused by Klebsiella oxytoca. A 79-year-old man with a history of antibiotic therapy was admitted to our emergency department, complaining of consciousness disturbance. Initially, we suspected septic shock and diabetic ketoacidosis caused by intestinal infection. Although we administered sufficient extracellular fluid, his blood pressure was not elevated and his abdomen gradually swelled. Outcome The patient died of shock and abdominal compartment syndrome. Autopsy revealed widespread jejunal necrosis in conjunction with colitis, suggesting fulminant pseudomembranous enterocolitis caused by K. oxytoca infection. Conclusion As the clinical features of pseudomembranous enterocolitis caused by K. oxytoca resemble the features of colitis caused by Clostridium difficile, conservative therapy is applied first. However, fulminant pseudomembranous enterocolitis is a lethal disease, necessitating early operation for resection of the necrotic lesion. This report highlights the need for better surgical criteria at an early stage.
- Published
- 2018