# Iliopsoas Abscess, Spondylodiscitis, Septic Pulmonary Embolism, and Symmetrical Peripheral Gangrene by Hypermucoviscous Klebsiella pneumoniae

## TL;DR

A rare and severe infection caused by hypermucoviscous Klebsiella pneumoniae was successfully treated with long-term antibiotics and supportive care.

## Contribution

This case report highlights the successful treatment of a complex hmKP infection involving multiple severe complications.

## Key findings

- The patient was infected with hypermucoviscous Klebsiella pneumoniae causing iliopsoas abscess, spondylodiscitis, septic pulmonary embolism, and SPG.
- A 148-day antibiotic therapy with rifampicin and supportive care led to a good clinical outcome.
- Non-invasive ventilation and hemodialysis were part of the successful treatment strategy.

## Abstract

Hypermucoviscous Klebsiella pneumoniae (hmKP) is a bacterium known to cause lesions, including abscesses, in various organs. Unlike typical Klebsiella pneumoniae, hmKP can yield a positive string test in culture specimens. Infections caused by hmKP often become severe and are associated with a poor prognosis. In this report, we describe a case of iliopsoas abscess, spondylodiscitis, septic pulmonary embolism, and symmetrical peripheral gangrene (SPG) caused by hmKP. The patient received non-invasive positive-pressure ventilation, hemodialysis, platelet transfusions, fresh frozen plasma, thrombomodulin, and intensive antibiotic therapy including rifampicin. The patient underwent 148 days of antibiotic therapy and achieved a good outcome.