Fatal Gas Gangrene Caused by Klebsiella Pneumoniae
克雷伯氏肺炎桿菌造成的致命氣性壞疽
Journal
The Journal of Taiwan Society of Plastic Surgery = 中華民國整形外科醫學會雜誌
Journal Volume
18
Journal Issue
3
Pages
240 - 246
Date Issued
2009-09-01
Author(s)
Abstract
Background: Gas gangrene, also known as crepitant myonecrosis, is well-known to be most commonly caused by Clostridium species. Previous reports have revealed that nonclostridial involvement may be more prevalent. Klebsiella pneumoniae (K. pneumoniae) gas gangrene is a rare but fatal disease. Aim and Objectives: By a through clinical review, we would like to identify the characteristic clinical features of this disease and the reasons of its high fatality. Material and Methods: A retrospective chart review was performed in National Taiwan University Hospital from 2003~2008. The data was supplemented with a literature search. We collected a series of 6 patients K. pneumoniae gas gangrene. The clinical features, laboratory and image findings were recorded. Results: A painful swelling limb is the most common presentation. There were three cases reported previously in the literature. A review of these six patients showed that most patients (67%) were in immunosuppressant status or had diabetes. The cause was inconspicuous in 83% patients. The diagnosis of K. pneumoniae gas gangrene was delayed from 3 to 32 days in five of the six patients. Mortality was 100%. Conclusion: We speculate the cause of high fatality lies in the non-specific presentation of the disease, which delays the diagnosis. High clinical suspicion and prompt surgical debridement may be the key to improved survival.
SDGs
Publisher
中華民國整形外科醫學會
Type
journal article