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Updated: Mar 19 2021


  • Snapshot
    • A 55-year-old man is brought to the emergency department by police after being found confused in the park. Obtaining a history is difficult. On physical exam, the patient smells of alcohol and has a productive cough of red currant jelly. There are decreased breath sounds in the right lung fields. A chest radiograph is obtained, which demonstrates a lobar consolidation concerning for pneumonia. A sputum culture demonstrates Gram-negative bacilli that are facultative anaerobes and lactose fermenting. They have a mucoid appearance on MacConkey agar.
  • Introduction
    • Classification
      • a gram-negative, lactose-fermenting, facultative anaerobic bacilli
    • Microbiology
      • contains an abundant polysaccharide capsule leading to mucoid colonies
    • Associated conditions
      • granuloma inguinale
      • community-acquired pneumonia
      • lung abscess
      • aspiration pneumonia
      • urinary tract infection
      • invasive liver abscess syndrome
  • Presentation
    • Symptoms/physical exam
      • pneumonia
        • red currant jelly sputum
          • typically seen in patients with diabetes and alcohol use disorder
      • sexually transmitted infection
        • chronic genital ulcers
      • urinary tract infection
        • dysuria
        • urinary frequency
        • urinary urgency
        • suprapubic pain
      • invasive liver abscess
        • right upper quadrant pain
  • Studies
    • Culture
      • obtained from possible sites of infection
        • mucoid and pink colonies on MacConkey agar
  • Treatment
    • Medical
      • third generation cephalosporins, carbapenems, aminoglycosides, and quinolones
        • indication
          • these agents have activity against Klebsiella; however, susceptibility testing will dictate which antibiotic is best
  • Complications
    • Sepsis
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