This case report describes a neck abscess caused by a strain of Hypervirulent Klebsiella pneumoniae in a middle aged man with diabetes without a history of travel to East and South East Asia. This case report is of notable significance as Hypervirulent Klebsiella pneumoniae neck abscesses are rarely seen in the UK and are very infrequently documented in individuals who have not first travelled to the high prevalence areas of East and South East Asia. This case report describes a 53 year old diabetic man who contracted a Hypervirulent Klebsiella pneumoniae neck abscess which led to the development of sepsis. Klebsiella pneumoniae was cultured from blood cultures and fluid aspirated from the abscess grew the pathogen with same antimicrobial susceptibility. Hypervirulence was demonstrated after the samples were analysed, at the Antimicrobial Resistance and Healthcare Associated Infections Reference Unit Public Health England Colindale, and found to contain the K20 (rmp)A and rmpA2 virulence genes. Hypervirulent Klebsiella pneumoniae is a Gram-negative, encapsulated, non-motile bacillus notable for its ability to metastatically spread and cause potentially life threatening infections in otherwise healthy adults, but especially in those with diabetes. Genes responsible for the production of hyperviscous mucoid polysaccharide capsules and siderophores, such as those isolated in this case, enable the bacteria to more efficiently evade the hosts immune system and disseminate and invade surrounding and distant tissues. Data from Public Health England shows Hypervirulent Klebsiella pneumoniae are rare in the UK. A review of current literature also showed Hypervirulent Klebsiella pneumoniae almost exclusively occur in those who have traveled to East and South East Asia. This case reported a rare Hypervirulent Klebsiella pneumoniae neck abscess outside of, and without travel to, East and South East Asia. This raises concerns about future, potentially life threatening, Hypervirulent Klebsiella pneumoniae infections becoming more widespread without the need for endemic travel. This concern is further exacerbated by the growing global challenge of antimicrobial resistance.

中文翻译：

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罕见高毒力肺炎克雷伯菌、荚膜型K20和序列型420引起的颈部脓肿一例

本病例报告描述了一名没有东亚和东南亚旅行史的患有糖尿病的中年男子由高毒力肺炎克雷伯菌菌株引起的颈部脓肿。该病例报告具有显着意义，因为高毒力肺炎克雷伯菌颈部脓肿在英国很少见，并且在没有首次前往东亚和东南亚高流行地区的个人中也很少见。本病例报告描述了一名 53 岁的糖尿病男性，他感染了高毒性肺炎克雷伯菌颈部脓肿，导致败血症的发展。肺炎克雷伯菌是从血培养物中培养出来的，从脓肿中抽吸的液体中培养出具有相同抗菌敏感性的病原体。分析样品后证明了超毒力，在抗微生物药物耐药性和医疗保健相关感染参考单位公共卫生英格兰科林代尔，发现含有 K20 (rmp)A 和 rmpA2 毒力基因。高毒力肺炎克雷伯菌是一种革兰氏阴性、有包膜、无运动性的芽孢杆菌，因其在其他健康成年人中转移性传播和引起可能危及生命的感染的能力而著称，尤其是在糖尿病患者中。负责产生高粘性粘液多糖胶囊和铁载体的基因，例如在这种情况下分离的那些，使细菌能够更有效地逃避宿主免疫系统并传播和侵入周围和远处的组织。英国公共卫生部门的数据显示，高毒力的肺炎克雷伯菌在英国很少见。对当前文献的回顾还表明，高毒力肺炎克雷伯菌几乎只发生在去过东亚和东南亚的人身上。该病例报告了一种罕见的高毒力肺炎克雷伯菌颈部脓肿，在东亚和东南亚以外地区且没有去过东亚和东南亚地区。这引起了人们对未来可能危及生命的高毒力肺炎克雷伯菌感染在不需要地方性旅行的情况下变得更加普遍的担忧。日益严峻的全球抗微生物药物耐药性挑战进一步加剧了这种担忧。可能危及生命的高毒力肺炎克雷伯菌感染变得更加普遍，而无需进行地方性旅行。日益严峻的全球抗微生物药物耐药性挑战进一步加剧了这种担忧。可能危及生命的高毒力肺炎克雷伯菌感染变得更加普遍，而无需进行地方性旅行。日益严峻的全球抗微生物药物耐药性挑战进一步加剧了这种担忧。