• H Baudrand, B H Mbatchou Ngahane, M Marcu, N Freymond, Y Pacheco, and G Devouassoux.
• Service de Pneumologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, et Université Claude Bernard, Lyon, France.
• Rev Mal Respir. 2009 Sep 1; 26 (7): 773-8.

IntroductionIn western countries, community-acquired pneumonias due to Klebsiella pneumoniae (Kp) are rare and associated with a poor prognosis and a high mortality. The severity is in part linked to the virulence of Kp. Immuno-depression, sepsis and visceral abscesses are frequently found, constituting other classical risk factors for severity and contributing to the poor prognosis. The therapeutic strategy is based on third generation cephalosporins, aminoglycosides and quinolones.Case ReportWe report the case of a young adult, with undiagnosed diabetes, hospitalized as an emergency for septic shock complicating a community-acquired pneumonia due to Kp and associated with multiple brain and lung abscesses. After several weeks of treatment, initially with empirical then specific antibiotics, a favourable outcome was obtained.ConclusionThis case report underlines the particular severity of infections due to Kp and their main pathophysiological mechanisms. It is also an opportunity to highlight the potential responsibility of Kp in the presence of a pneumonia with lung abscesses and finally to update the principles of antibiotic therapy.

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