# An unusual case of necrotizing pneumonia in a healthy apnea diver

## TL;DR

A healthy apnea diver developed severe pneumonia from a rare, aggressive strain of Klebsiella bacteria that required long-term treatment.

## Contribution

Highlights an unusual case of hypervirulent Klebsiella pneumoniae causing necrotizing pneumonia in a previously healthy individual.

## Key findings

- Hypervirulent Klebsiella pneumoniae caused necrotizing pneumonia in a healthy apnea diver.
- The infection required 6 months of high-dose antibiotics despite not being multi-drug resistant.
- Hypervirulence was only considered after initial treatments failed.

## Abstract

We report a case of necrotizing pneumonia caused by hypervirulent Klebsiella pneumoniae in an athletic, 54-year-old apnea diver. Since hypervirulent Klebsiella pneumoniae strains prevail in Southeast Asia and are mainly associated with “invasive liver abscess syndrome”, we considered and tested for hypervirulence only when the necrotizing pneumonia turned out to be refractory to initial antibiotic treatment. Although the hypervirulent Klebsiella pneumoniae strain in our patient did not show multi-drug resistance, a total of 6 months of high-dose antibiotic therapy was necessary to cure the infection.