Intracranial dissemination of Klebsiella pneumoniae originating from pulmonary infection: a case report

TL;DR

A rare case of brain abscesses caused by Klebsiella pneumoniae originating from a lung infection is reported, highlighting the importance of early diagnosis and treatment.

Contribution

This case report presents a rare instance of Klebsiella pneumoniae-induced brain abscesses from a pulmonary source.

Findings

The patient's brain abscesses originated from a pleural abscess caused by Klebsiella pneumoniae.

Despite antibiotic therapy, the patient's condition worsened, leading to loss of consciousness.

Early detection and appropriate management are crucial for improving outcomes in such rare cases.

Abstract

Metastatic brain abscesses caused by Klebsiella pneumoniae are extremely rare but life-threatening conditions. To depict a unique case of the middle-aged hypertensive man with an unusual presentation of metastatic brain abscesses originating from a pleural abscess caused by Klebsiella pneumoniae and subsequently leading to loss of consciousness (LOC).

A 52-year-old Iranian man with a history of hypertension presented to the emergency department with a five-day history of worsening cough, high-grade fever, shortness of breath, chest pain, fatigue, and a productive cough. Laboratory tests revealed leukocytosis, elevated C-reactive protein, and respiratory alkalosis. A chest computed tomography scan confirmed pneumonia, and a brain scan revealed multiple hypodense lesions. Despite antibiotic therapy, the patient's condition worsened, leading to confusion, disorientation, and loss of consciousness. Magnetic resonance imaging revealed multiple ring-enhancing lesions, suggesting an abscess formation. Bronchial washings and BAL samples confirmed a lower respiratory tract infection. Cultures from the bronchial washings grew Klebsiella pneumoniae.

Metastatic brain abscesses caused by Klebsiella pneumoniae are exceedingly rare but life-threatening conditions. Timely diagnosis and effective antimicrobial treatment are critical for patient outcomes. This case underscores the significance of recognizing atypical presentations of bacterial infections, as early detection and appropriate management can significantly impact patient outcomes.

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