Department of Critical Care Medicine, People's Hospital of Yangjiang, Yangjiang, Guangdong, 529500, China.
Precision Medical Lab Center, People's Hospital of Yangjiang, Yangjiang, Guangdong, 529500, China.
BMC Infect Dis. 2024 Aug 13;24(1):820. doi: 10.1186/s12879-024-09721-2.
Pulmonary abscesses resulting from epididymitis caused by extended spectrum β-lactamase-producing hypervirulent Klebsiella pneumoniae (ESBL-hvKp) in a nondiabetic patient are extremely uncommon. The infection caused by this disseminated drug-resistant bacteria, which is generally considered an intractable case, poses a potential challenge in clinical practice.
In this case report, we present the clinical course of a 71-year-old male patient with epididymitis, who subsequently developed cough and dyspnea following anti-infection treatment. Imaging examinations revealed severe pneumonia and pulmonary abscess. The infection of ESBL-hvKp in the epididymis led to bacteremia and subsequent lung lesions. Due to poor response to anti-infection therapy, the patient required an extended duration of anti-infection treatment and ultimately chosed to discontinue treatment.
Acute epididymitis caused by ESBL-hvKP infection can result in the spread of the infection through the bloodstream, leading to severe pneumonia and lung abscess. Given the critical condition of the patient, even with active anti-infection treatment, there is a risk of treatment failure or potentially fatal outcomes.
由产extended spectrum β-lactamase-producing hypervirulent Klebsiella pneumoniae（ESBL-hvKp）引起的非糖尿病患者的附睾炎导致的肺脓肿极其罕见。这种传播性耐药菌引起的感染通常被认为是难治性病例，在临床实践中构成了潜在挑战。
在本病例报告中，我们介绍了一位 71 岁男性患者的临床病程，他在接受抗感染治疗后出现咳嗽和呼吸困难。影像学检查显示严重肺炎和肺脓肿。附睾处 ESBL-hvKp 的感染导致菌血症和随后的肺部病变。由于对抗感染治疗的反应不佳，患者需要延长抗感染治疗时间，并最终选择停止治疗。
由 ESBL-hvKP 感染引起的急性附睾炎可通过血液传播导致严重肺炎和肺脓肿。鉴于患者的危急状况，即使进行积极的抗感染治疗，仍存在治疗失败或潜在致命结局的风险。
