A Case of Pneumonia, Septic Pulmonary Embolisms with Cavities, Bilateral Large Lung Abscesses, and Multiple Liver Abscesses Caused by Klebsiella pneumoniae
Akihiro Yoshimoto1) Hiroshi Tsuji1) Eisuke Takazakura1) Masaki Fujimura2)
1)Department of Internal Medicine, Kurobe City Hospital, Mikkaichi 1108-1, Kurobe, Japan
2)The Third Department of Internal Medicine, Kanazawa University School of Medicine, Takaramachi 13-1, Kanazawa, Japan
A 64-year-old man suffering from diabetic hyperosmolar non-ketotic coma was admitted for acute lung abscess in the left apical lung field. Sputum culture and blood culture showed a heavy growth of Klebsiella pneumoniae (K. pneumoniae). He was suffering from sepsis, septic pulmonary embolisms with cavities, bilateral pulmonary consolidations, and multiple liver abscesses. Gradually, the bilateral lung consolidations resolved and areas of consolidation were noted to undergo extensive cavitation bilaterally. Cavitation and abscess formation are frequent complications of K. pneumoniae. Generally, large bilateral lung abscesses caused by K. pneumoniae have a poor prognosis. Cavity nodules are often present in septic pulmonary embolisms. We report a very rare case in a patient with three types of cavities with differing mechanisms. The first was an acute lung abscess, the second, septic pulmonary embolisms with cavities, and the third, large bilateral lung cavities noted in the course of resolving consolidations.
Klebsiella pneumoniae Lung abscess Septic pulmonary embolism
Received 平成12年8月22日
JJRS, 39(6): 405-409, 2001