Klebsiella pneumoniae septic pulmonary embolism from renal vein thrombosis.
Makoto Nojo, Shin Ohta, Yosuke Fukuda et al.
✦ AI-curated · Sources linked
Case in brief
A 47-year-old woman with untreated diabetes presented with urinary symptoms, fever, abdominal pain, and hypoxemia. Blood and urine cultures confirmed Klebsiella pneumoniae, with persistent bacteremia despite meropenem treatment. Imaging revealed renal vein thrombosis and cavitary pulmonary nodules. Management was adjusted to ceftriaxone and levofloxacin, leading to resolution of the thrombus and pulmonary lesions by day 38.
What made this case unusual
The case highlights a presumed hypervirulent strain of Klebsiella pneumoniae causing septic pulmonary embolism secondary to renal vein thrombosis, which is an atypical complication of urinary tract infections.
Diagnostic / clinical pearl
Clinicians should consider the possibility of septic venous sources in patients with persistent bacteremia and cavitary pulmonary lesions, especially in the context of urinary infections and renal abscesses.
Why it matters
This case underscores the importance of thorough evaluation for underlying venous thrombosis in patients presenting with septic emboli, particularly those with risk factors like diabetes.