Indiana University Infectious Diseases Fellowship
14 Jan,
5 tweets, 4 min read
#idboardreview 80 M originally from Philippines w/ yearly travel there, presents w/ fever, abd pain, chills, inc LFTs, +liver abscess. BC+ organism? #meded #idmeded #idtwitter 
hypervirulent #klebsiella pneumoniae liver abscess Ref academic.oup.com/ofid/article/7…
Infections with #hypervirulent #Klebsiella pneumoniae isolates most frequently occur among pts with an Asian, Pacific Islander, or Hispanic ethnic background, even in absence of travel to high-prevalence areas (eg, Asian Pacific Rim). Diabetes is also a risk factor
#hypervirulent #Klebsiella +virulence genes rmpA, iucA, & iroB
#rmpA enhaces capsular polysaccharide synthesis, while #iucA #iroB encode siderophores aerobactin & salmochelin respectively
mucoid colonies on solid agar media+string test (sensitivity89% specificity 91%)
#rmpA enhaces capsular polysaccharide synthesis, while #iucA #iroB encode siderophores aerobactin & salmochelin respectively
mucoid colonies on solid agar media+string test (sensitivity89% specificity 91%)
For patients suspected hypervirulent #klebsiella liver perform additional diagnostic studies (eg, imaging, ocular exam) to fully define extent of infection given the propensity for metastatic spread
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