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Hypervirulent Klebsiella pneumoniae (HV-KP) is typically associated with community-acquired liver abscess and bacteremia with metastatic infection; however, primary lung abscess (PLA) caused by HV-KP is rare, with only one such case report to date. A 69-year-old man with a history of diabetes mellitus (DM) was admitted to hospital complaining of slight bloody sputum. Chest imaging showed multiple consolidations with cavities in both lung fields. A culture of bronchoalveolar lavage fluid confirmed the presence of K. pneumoniae. Genetic analyses identified the isolate as serotype K2 and sequence type 375 (K2-ST375), and that it harbored the rmpA gene. The patient was an Asian middle-aged male with DM, all of which are risk factors for HV-KP infection. Although complicating DM and the presence of the rmpA gene are more likely to induce disseminated infection, metastatic infections were not found in this patient. The clinical and microbiological characteristics of our patient were different from those of a previous reported case, although in both cases the patient was from Asia and had DM. Therefore, DM appears to be one of the predisposing factors for HV-KP lung abscesses and physicians should pay attention to emerging HV-KP lung abscess infection, particularly in Asian countries. Previous studies have also revealed that K2-ST375 is one of the major clones causing HV-KP infection, and that it is mainly isolated from patients with liver abscess. Interestingly, including the present case, most of the infectious cases caused by K2-ST375 have been reported from Okinawa Prefecture in Japan. Therefore, the trend of the K2-ST375 strain should be carefully monitored, particularly in Okinawa, Japan. The serotype of HV-KP that causes PLA is still unknown and further study is needed to elucidate the etiology of PLA due to HV-KP and the relationship between the strain K2-ST375 and PLA. [ABSTRACT FROM AUTHOR]

NTM‐SPN is often indistinguishable from malignancy. Although surgical resection is sometimes chosen for the diagnosis and treatment, the mass in this case shrank spontaneously. Careful observation is required to avoid unnecessary interventions. [ABSTRACT FROM AUTHOR]

When observing diffuse ground‐glass opacities in both lungs, physicians should consider several diseases, including heart failure, interstitial lung diseases, and pulmonary infections. However, brain diseases rarely cause lung infiltration. We present an instructive case of neurologic pulmonary edema showing a pathological link between the brain and the lung. [ABSTRACT FROM AUTHOR]

Abstract: Previously, we demonstrated that Vα14+ NKT cells and IFN-γ are important upstream components in neutrophil-mediated host defense against infection with Streptococcus pneumoniae. In the present study, we extended these findings by elucidating the role of IFN-γ in this Vα14+ NKT cell-promoted process. Administration of recombinant IFN-γ to Jα18KO mice prolonged the shortened survival, promoted the attenuated clearance of bacteria and improved the reduced accumulation of neutrophils and synthesis of MIP-2 and TNF-α in the lungs, in comparison to wild-type (WT) mice. In addition, intravenous transfer of liver mononuclear cells (LMNC) from WT mice into Jα18KO mice resulted in complete recovery of the depleted responses listed above, whereas such effects were not detected when LMNC were obtained from IFN-γKO or Jα18KO mice. Activation of Vα14+ NKT cells by α-galactosylceramide (α-GalCer) significantly enhanced the clearance of bacteria, accumulation of neutrophils and synthesis of MIP-2 and TNF-α in the infected lungs; this effect was significantly inhibited by a neutralizing anti-IFN-γ antibody. Finally, in a flow cytometric analysis, TNF-α synthesis was detected largely by CD11bbright+ cells in the infected lungs. Our results demonstrated that IFN-γ plays an important role in the neutrophil-mediated host protective responses against pneumococcal infection promoted by Vα14+ NKT cells. [Copyright &y& Elsevier]

Abstract: The present study was designed to elucidate the role of Vγ4+ γδ T cells, a major subset of pulmonary γδ T cells, in host defense against infection with Streptococcus pneumoniae. The proportion and number of whole γδ T cells, identified as CD3+ and TCR-δ+ cells, and Vγ4+ γδ T cells, identified as CD3+ and TCR-Vγ4+ cells, increased in the lungs at 3, 6 and 12h post-infection. Survival of infected mice and lung bacterial clearance were severely impaired in TCR-Vγ4−/− mice compared with control wild-type (WT) mice. The impaired host protection in TCR-Vγ4−/− mice correlated well with attenuated recruitment of neutrophils in lungs. MIP-2 and TNF-α synthesis in the infected tissues was significantly reduced in TCR-Vγ4−/− mice compared with WT mice. Similar results were noted in the synthesis of TNF-α, but not clearly of MIP-2, by lung leukocytes stimulated with live bacteria. Our results demonstrate that Vγ4+ γδ T cells play an important role in the neutrophil-mediated host defense against S. pneumoniae infection by promoting the synthesis of TNF-α and possibly of MIP-2 in the lungs. [Copyright &y& Elsevier]