1. Klebsiella pneumoniae meningitis in a 38-year-old Chinese traveller with impaired glucose tolerance: a new emerging syndrome?
- Author
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Boglione L, Spezia C, Lipani F, Balbiano R, Canta F, Marrone R, De Agostini M, Calleri G, and Caramello P
- Subjects
- Adult, China ethnology, Community-Acquired Infections epidemiology, Endophthalmitis epidemiology, Glucose Intolerance complications, Humans, Klebsiella Infections epidemiology, Klebsiella pneumoniae isolation & purification, Male, Meningitis, Bacterial epidemiology, Risk Factors, Community-Acquired Infections diagnosis, Endophthalmitis diagnosis, Klebsiella Infections diagnosis, Klebsiella pneumoniae pathogenicity, Meningitis, Bacterial diagnosis, Travel
- Abstract
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.
- Published
- 2008
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