Prince S E, Dominger K A, Cunha B A, Klein N C
Infectious Disease Division, Winthrop-University Hospital, Mineola, NY 11501, USA.
Heart Lung. 1997 Sep-Oct;26(5):413-7. doi: 10.1016/s0147-9563(97)90028-5.
Klebsiella pneumoniae is an uncommon cause of community-acquired pneumonia except in alcoholics. Klebsiella may mimic pulmonary reactivation tuberculosis because it presents with hemoptysis and cavitating lesions. Klebsiella pneumoniae is a difficult infection to treat because of the organism's thick capsule. Klebsiella is best treated with third- and fourth-generation cephalosporins, quinolones, or carbapenems. Monotherapy is just as effective as a combination treatment in Klebsiella pneumoniae because newer agents are used. In the past, older agents with less anti-Klebsiella activity were needed for effective treatment. The patient we present was initially thought to have pulmonary tuberculosis, and when found to have Klebsiella pneumoniae, the suggested treatment was monotherapy with ceftriaxone. The patient was treated parenterally initially, and then was treated for 3 weeks with oral ofloxacin.
肺炎克雷伯菌是社区获得性肺炎的罕见病因,但在酗酒者中除外。肺炎克雷伯菌可能会模仿肺结核复发,因为它会出现咯血和空洞性病变。由于该菌有厚厚的荚膜,肺炎克雷伯菌感染很难治疗。治疗肺炎克雷伯菌最好使用第三代和第四代头孢菌素、喹诺酮类药物或碳青霉烯类药物。在肺炎克雷伯菌感染中,单一疗法与联合治疗一样有效,因为使用了更新的药物。过去,需要使用抗肺炎克雷伯菌活性较低的旧药才能进行有效治疗。我们介绍的这位患者最初被认为患有肺结核,当发现患有肺炎克雷伯菌时,建议的治疗方法是用头孢曲松进行单一疗法。患者最初接受肠外治疗,然后口服氧氟沙星治疗3周。