GoKawiilA 63-year-old woman arrived at a hospital in pain. She had abruptly lost vision in her right eye. As doctors got to work, the series of findings that followed revealed not just bad news for her, but an alarming revelation of how infections can evolve within a patient.
The woman’s remarkable case was reported this week in the New England Journal of Medicine. According to her doctors, initial magnetic resonance imaging scans of her brain quickly identified the key problem. The imaging indicated inflammation in her right eye, but also picked up lesions in her brain. Specifically, the imaging suggested problems in her parietal lobe, which is a hub for processing sensory information.
The doctors suspected she had a brain abscess. Laboratory results of her blood and urine samples suggested an infection as well as kidney problems. Doctors decided to open up her skull for a brain biopsy. Inside, the surgical team was met with pus. Meanwhile, doctors worked to identify the bacteria found in two urine samples.
In all, the two urine samples and the brain sample all grew the same bacteria: Klebsiella pneumoniae. This is a bacterium well known to doctors. It often dwells in the gastrointestinal tract, but can lurk in healthcare settings and spark infections, particularly pneumonia and urinary tract infections. It’s also known for having a variant that can go metastatic, traveling via the bloodstream to invade other organs, particularly the liver, but also the lungs, eyes, and brain.
In a standard case report, this might be the end of the story. Doctors would diagnose a disseminated K. pneumoniae infection and treat with antibiotics. But there was more.