Klebsiella Pneumoniae-related Brain Abscess and Meningitis in Adults: Case Report and Literature Review

Abstract Background: Despite the progress of modern neurosurgical techniques, new antibiotics and modern imaging techniques, brain abscess is still a potentially fatal infection. Streptococci have always been the common organisms resulting in brain abscess. Nevertheless, Klebsiella species, once thought to be a less common cause of brain abscess in adults, have become an increasingly important cause of brain abscess, especially in Asia. Case presentation: A 64-year-old woman felt sudden onset severe continuous headache, accompanied by intermittent nausea, vomiting and fever. Meanwhile, she felt tinnitus and had a feeling of swelling in the right ear. Electroencephalogram (EEG) examination showed mild abnormality. A neurological examination revealed obvious nuchal rigidity with four transverse fingers under the chin. Cranial magnetic resonance imaging (MRI) revealed abnormal hyperintensities signals in the left head of caudate nucleus. The cerebral spinal fluid (CSF) common results indicated bacterial infection The next generation sequencing (NGS) of CSF showed the infection of K pneumoniae. The patient was diagnosed with Klebsiella pneumoniae-related brain abscess and meningitis. After positive antimicrobial treatment for nearly two months. The patient got a good recovery.Conclusion: K pneumoniae is once thought to be a less common cause of brain abscess in adults and mainly hospital-acquired. Community-acquired CNS infection (brain abscess and meningitis) caused by K pneumoniae without other metastatic septic abscesses is exceedingly rare. Therefore, we present a rare adult patient with invasive cerebral abscess and meningitis without other invasive abscesses related to K pneumoniae.