Key result
Multidrug-resistant Klebsiella aerogenes emerges as a rare cause of fatal purulent pericarditis after chest trauma.
Why the study?
Purulent pericarditis has shifted increasingly toward gram-negative bacteria, but Klebsiella aerogenes had never previously been reported as a causative pathogen.
Case Report (n=1)
Klebsiella aerogenes is a rare but potentially fatal cause of purulent pericarditis that requires consideration in patients with atypical risk factors and may present with multidrug resistance.
Raises suspicion for MDR Klebsiella in traumatic pericarditis; leaves open need for incidence data and management guidance.
Purulent pericarditis is a rare but serious medical condition caused by an infection that spreads to the pericardial space surrounding the heart. Gram-positive organisms are the most common pathogens associated with purulent pericarditis. However, there has been a shift in recent years toward gram-negative bacteria. Klebsiella aerogenes is a rare pathogen that has never been linked to purulent pericarditis. In this report, we describe the case of a 40-year-old male patient with chronic bronchiectasis who, two months after suffering an injury, developed purulent pericarditis due to an uncommon organism, K. aerogenes. During his stay in the hospital, the patient developed several infections caused by K. aerogenes. These included bacteremia and ventilator-associated pneumonia (VAP). Beta-lactamase-inducible K. aerogenes was grown in pericardial fluid culture following an emergency pericardiocentesis. The organism was resistant to carbapenems in a sputum culture, even though it was sensitive to meropenem in a blood culture. The patient had hypotension, requiring inotropes, and continued persistent bacteremia due to K. aerogenes. The patient had a heart attack with no pulse or electrical activity and died despite getting the best care possible. In light of this example, it is crucial to think about K. aerogenes and other rare organisms as possible pathogens in purulent pericarditis, especially in people who do not normally have known risk factors for this condition. Multidrug resistance patterns can make treatment more complicated, and aggressive care may be necessary in critically ill patients with chronic bacteremia.
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Kim et al. (2024) conducted a case report in Purulent pericarditis (n=1). Klebsiella aerogenes infection was evaluated. A 40-year-old male with a traumatic chest injury developed fatal purulent pericarditis caused by multidrug-resistant Klebsiella aerogenes, highlighting it as a potential rare pathogen.
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