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Microbes & Immunity Rare multi-site Klebsiella pneumoniae infections

consultation is crucial for necrotizing fasciitis patients, Funding
as early surgery improves outcomes. Debridement and
fasciotomies, aimed at removing all necrotic tissue, are This study was supported by the Shen Kang Hospital
vital for recovery. Development Center Project for Technical Standardization
Management and Promotion (Grant no. SHDC22023239),
The cases presented in this case series highlight and the Shanghai Hospital Development Center
several key points. First, the diagnostic process for hvKP Foundation (Grant no. SHDC22022206).
infections necessitates thoroughness and swiftness,
employing advanced techniques such as mNGS alongside Conflict of interest
traditional culture methods to accurately identify the The authors declare no conflicts of interest.
pathogen and its resistance profile. Second, the choice of
antimicrobial therapy must be guided by susceptibility Author contributions
testing, with consideration given to combination therapy
to address potential resistant strains and prevent the Conceptualization: Ruilan Wang
Data curation: All authors
development of resistance during treatment. Moreover, Formal analysis: Shanshan Jin, Lina Zhao, Qiuping Huang
the management of underlying conditions, particularly
diabetes, holds paramount importance in the treatment Investigation: Jian Lu, Yu Zhang, Lina Zhao
of hvKP infections. Maintaining strict glycemic control Methodology: Yu Zhang, Hui Xie
can significantly reduce the risk of infection and improve Supervision: Ruilan Wang
Writing – original draft: Shanshan Jin
the efficacy of antimicrobial therapy. In addition, patient Writing – reviewing & editing: Ruilan Wang
education regarding the signs and symptoms of hvKP
infections can facilitate earlier medical intervention, Ruilan Wang, as the principal corresponding author,
thereby further improving patient outcomes. played a pivotal role in the overall conceptual design and
critical revisions of the manuscript, and Jian Lu, as the
4. Conclusion co-corresponding author, significantly contributed to the
Multi-site KP infections, though rare, can inflict collection of clinical data.
significant disability and death worldwide. KP exhibits Ethics approval and consent to participate
a predilection for individuals with high-risk underlying
diseases, particularly those who are immunocompromised Shanghai General Hospital Institutional Review Board
and/or diabetes mellitus. Therefore, emergency physicians has reviewed the study and has determined that this is a
should maintain heightened vigilance for KP infections retrospective study that the design is scientific and is up
among patients with risk factors such as diabetes, and to the ethics standards. The Institutional Review Board
conduct assessments for metastatic abscesses. Managing thus approved the study. All participants or their family
KP infections involves a holistic approach to infectious members provided informed consent for participation in
diseases, with an emphasis on prevention in the practice of this study and for the submission of this case series to the
every emergency physician. Early intervention strategies, journal.
such as prompt administration of suitable antibiotics,
management of internal conditions such as blood sugar Consent for publication
levels, and immediate abscess drainage, are crucial for Consent for publication has been obtained from the
markedly enhancing patient prognosis. In our clinic, strict patients reported in this article. Also, each patient’s next-
glucose control, early abscess drainage, and appropriate of-kin has given written consent for their relative’s personal
antibiotics led to favorable outcomes in three patients. or clinical details along with any identifying images to be
Prompt initiation of antibiotics, adherence to consistent published in this study.
dosing, and extended treatment duration are crucial for
effective management. Availability of data

Acknowledgments The data that support the findings of this study are available
from the corresponding author on reasonable request.
The authors thank radiological technicians and
neurosurgeons for their efforts in the clinical diagnosis and References
management of this patient. The authors thank all patients 1. Friedlander C. On the schizomycetes in acute fibrous
and staff nurses who have been involved directly in the pneumonia. Virchows Arch Pathol Anat Physiol Clin Med.
study. 1882;87:319-324.

Volume 1 Issue 1 (2024) 118 doi: 10.36922/mi.2600