Open AccessFulminant pseudomembranous enterocolitis caused by Klebsiella oxytoca : an autopsy case report
Author(s) -
Nagamura Tatsunori,
Tanaka Yoshihiro,
Terayama Takero,
Higashiyama Daishi,
Seno Soichiro,
Isoi Naoaki,
Katsurada Yuka,
Matsubara Akiko,
Yoshimura Yuya,
Sekine Yasumasa,
Akitomi Shinji,
Sato Kimiya,
Tsuda Hitoshi,
Saitoh Daizoh,
Ikeuchi Hisashi
Publication year - 2019
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.370
Subject(s) - medicine , fulminant , enterocolitis , klebsiella oxytoca , autopsy , septic shock , surgery , pseudomembranous colitis , gastroenterology , sepsis , clostridium difficile , antibiotics , microbiology and biotechnology , klebsiella pneumoniae , biochemistry , chemistry , escherichia coli , biology , gene
Case We describe a rare case of antibiotic‐associated fulminant pseudomembranous enterocolitis caused by Klebsiella oxytoca . A 79‐year‐old man with a history of antibiotic therapy was admitted to our emergency department, complaining of consciousness disturbance. Initially, we suspected septic shock and diabetic ketoacidosis caused by intestinal infection. Although we administered sufficient extracellular fluid, his blood pressure was not elevated and his abdomen gradually swelled. Outcome The patient died of shock and abdominal compartment syndrome. Autopsy revealed widespread jejunal necrosis in conjunction with colitis, suggesting fulminant pseudomembranous enterocolitis caused by K. oxytoca infection. Conclusion As the clinical features of pseudomembranous enterocolitis caused by K. oxytoca resemble the features of colitis caused by Clostridium difficile , conservative therapy is applied first. However, fulminant pseudomembranous enterocolitis is a lethal disease, necessitating early operation for resection of the necrotic lesion. This report highlights the need for better surgical criteria at an early stage.