Intensive care management of community-acquired Klebsiella pneumoniae

Respir Med. 1991 Jan;85(1):11-6. doi: 10.1016/s0954-6111(06)80204-0.

Abstract

The clinical features of 18 patients with Klebsiella pneumoniae requiring intensive care unit (ICU) management are presented. All patients required ventilatory support; 17 were given constant positive pressure ventilation and 10 required greater than 10 cm positive end expiratory pressure. The clinical picture was characteristic: pre-existing medical disease, clinical features of severe pneumonia and copious purulent bronchial secretions, Gram--ve organisms on Gram's stain and lobar consolidation on the chest radiograph were common. Septicaemic shock, confusion and uncompensated metabolic acidosis were the presenting clinical features predicting a poor outcome. Antimicrobial chemotherapy, that combined an aminoglycoside and a third generation cephalosporin to ensure adequate early antibiotic serum levels, may help to improve the prognosis.

MeSH terms

  • Acidosis / etiology
  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Critical Care*
  • Female
  • Humans
  • Klebsiella Infections / complications
  • Klebsiella Infections / diagnostic imaging
  • Klebsiella Infections / therapy*
  • Klebsiella pneumoniae*
  • Lung / diagnostic imaging
  • Male
  • Middle Aged
  • Pneumonia / therapy*
  • Positive-Pressure Respiration
  • Prognosis
  • Radiography
  • Retrospective Studies
  • Shock, Septic / etiology

Substances

  • Anti-Bacterial Agents