Which of the following is more likely associated with Klebsiella pneumoniae than Escherichia coli?
Correct Answer: An alcoholic who has lobar pneumonia
Description: Klebsiella pneumoniae is more likely than Escherichia coli to be associated with lobar pneumonia in an alcoholic. K pneumoniae is a fat, nonmotile, gram-negative rod that is surrounded by a capsule that is responsible for its invasiveness. They characteristically produce moist mucoid colonies on culture. K pneumoniae is a weak pathogen and requires a host with weak defenses (e.g., alcoholics, diabetics) to infected tissue. It is more commonly associated with urinary tract infections than with pneumonia. However, it produces a lobar pneumonia, paicularly in alcoholics, diabetics, or those with weakened defenses. The pneumonia are characterized by blood-tinged mucoid sputum, a tendency for lung abscesses, and a moality in 20% of patients. In general, K pneumonia is susceptible to ceftriaxone. Escherichia coli is the most common cause of acute cystitis and pyelonephritis, spontaneous bacterial peritonitis in alcoholics, the enterotoxigenic strain of traveler's diarrhea, hemolytic uremic syndrome in children caused by eating undercooked hamburgers, endotoxic shock, and acute cholecystitis. It is a common pathogen in neonatal meningitis, pneumonia in hospitalized patients caused by colonization of the airways by the organism, enteropathogenic gastroenteritis in infants under 2 years of age, enteroinvasive gastroenteritis with bloody diarrhea, peritonitis, wound infections (paicularly in diabetics), and septicemia. Ref - Harrison's principles of internal medicine 20e pg 1155,1146
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