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Klebsiella

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Topic updated on 02/16/17 5:51pm

Introduction
  • Classification
    • Bacteria
      • Gram-negative bacilli
        • The Enterics
          • facultative anaerobes
            • lactose fermenting
              • Klebsiella
                • K. pneumoniae
                • K. inguinale
  • Pathogenesis
    • transmission
      • endogenous
        • bacteria reach lungs by aspiration from upper respiratory tract (K. pneumoniae)
    • reservoir
      • upper respiratory tract
      • colon
    • molecular biology
      • large polysaccharide capsule
        • O antigen
      • endotoxin
  • The "4 A's"
    • aspiration pneumonia
    • abscesses in lungs
    • alcoholics
    • di-A-betics
Diseases
  • Pneumonia
    • red currant jelly sputum
      • can also be characterized as "mucoid-appearing" sputum
      • appearance of sputum distinguishes Klebsiella pneumonia from pneumococcal pneumonia
    • seen in
      • diabetics
      • alcoholics
      • hospitalized patients
    • destroys lung tissue
      • forms abscesses, especially in upper lobes
        • frequently confused with TB
    • high mortality
  • UTI
    • hospitalized patients with Foley catheters
    • contamination of catheters by feces
  • Sepsis
    • in immunocompromised
  • Liver abscess
    • RUQ pain, fever, malaise
    • MCC of pyogenic liver abscess, along with E. coli
  • K. inguinale
    • sexually transmitted infection
    • ulcerative genital lesion
    • ulcer is painless with a red base and irregular borders
    • Donovan bodies on histology
    • treatment is doxycycline/TMP-SMX
Laboratory
  • Mucoid colonies on MacConkey agar 
  • Oxidase negative
Treatment
  • 3rd generation cephalosporin
    • with or without aminoglycoside
  • Fluoroquinolones as an alternative


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