Klebsiella pneumoniae Necrotizing Fasciitis Associated with Lung Abscess
Aman Dalal, M.D., Maneesha Ahluwalia, M.D. and Carl Urban, Ph.D.
Necrotizing fasciitis is a rare, rapidly progressive, and life threatening infectious process primarily involving the fascia. It is perhaps the most aggressive form of soft tissue infection. Klebsiella pneumoniae is a nonmotile, rod-shaped, gram-negative bacterium with a prominent polysaccharide capsule and is a common cause of gram-negative bacteremias. Monomicrobial necrotizing fasciitis caused by K. pneumoniae is rare with only 12 documented cases in the literature, 10 cases from Asia and 1 each from Turkey and USA. These reports have become more frequent in recent years in association with the emergence of the highly virulent K1 capsular serotype K. pneumoniae. Majority of the cases occurring in Asia were associated with liver abscesses and eye involvement in diabetic patients. We report a case of K. pneumoniae necrotizing fasciitis associated with lung abscess in a nondiabetic patient. To our knowledge, K. pneumoniae monomicrobial necrotizing fasciitis associated with lung abscess has not been described previously. This is only the second case report of K. pneumoniae necrotizing fasciitis from USA.