Fatal systemic emphysematous infection caused by Klebsiella pneumoniae: A case report.

BACKGROUND: Systemic emphysematous infection caused by Klebsiella pneumoniae (K. pneumo niae) is a rare but severe infection which can be lethal if the diagnosis is delayed. CASE SUMMARY: We report a rare case of systemic emphysematous infection via hematogenous dissemination from a liver abscess caused by K. pneumoniae, complicated by multiple organ dysfunction syndrome, septic shock, bacteremia, emphysematous cystitis, prostate and left seminal vesicle abscesses in a diabetic patient. The patient simultaneously presented with spontaneous pneumoperitoneum secondary to rupture of the emphysematous liver abscess. His condition after admission deteriorated rapidly and he died within a short period. This disease is a great challenge for the clinician as K. pneumoniae can cause multifocal emphysematous infections and fulminant septic shock. Pneumoperitoneum following spontaneous rupture of the liver abscess can result in intra-abdominal sepsis that further increases mortality rate. Moreover, appropriate site-specific intervention and adequate drainage of numerous emphysematous liver lesions are difficult. CONCLUSION: Early diagnosis followed by efficient antibiotic therapy and surgical management are essential for systemic emphysematous infection.

[Toxoplasma gondii Infection in HIV-infected Individuals in Henan Province].

Genomic DNA was extracted from 1 038 peripheral blood samples from HIV-infected individuals in Henan Province. One-step single-tube nested PCR was performed to amplify the 529 bp repeating sequences of Toxoplasma gondii. Of the 1 038 samples （762 from males and 276 from females）, 66 showed positive PCR results, with a positive rate of 6.4%. The PCR positive rate in males and females was 6.3% （48/762） and 6.5% （18/276） respectively. The PCR positive rate in the married HIV individuals was 4.9%（25/508）, and that in unmarried, divorced and widowed HIV individuals was 7.7% （41/530）（χ2 = 3.451, P> 0.05）. The PCR positive rate in HIV individuals with a high-school educational level or above was 6.9%（34/489）, and that in those below the high-school level was 5.8% （32/549）（χ2 = 0.545, P> 0.05）. The highest infection rate was in the age group of 20-40 years（7.6%, 31/410）. In addition, the Toxoplasma infection rate in those with and without a history of venereal diseases, and those with an unknown history was 8.0%（9/113）, 6.5%（50/773） and 4.6%（7/152） respectively （χ2 = 0.355, P> 0.05）.