A FATAL CASE OF PNEUMOCEPHALUS LINKED TO HYPERMUCOVISCOUS, HYDROGEN-PRODUCING KLEBSIELLA PNEUMONIAE (K63) IN DIABETIC KETOACIDOSIS

• Mokoena Thornak

  Division of Infectious Diseases, University of Cape Town, South Africa

  Author

• Dr. Chloe D. Williamson

  Department of Infectious Diseases, University of Toronto, Canada

  Author

Imagine air trapped inside the skull – that's pneumocephalus, a rare but incredibly dangerous condition, especially when it's caused by gas-producing infections. This report shares the tragic story of a patient who developed extensive pneumocephalus and ultimately passed away. The culprit was a particularly aggressive strain of Klebsiella pneumoniae, a bacterium that not only produced a lot of sticky mucus but also generated hydrogen gas, all while the patient was battling severe diabetic ketoacidosis (DKA). When the patient arrived, his health was rapidly declining, and scans showed widespread air and multiple pockets of infection (abscesses) in his brain. Lab tests confirmed the highly virulent nature of the K. pneumoniae strain. Despite our best efforts with intensive medical care, the patient unfortunately succumbed within 48 hours. This case serves as a stark reminder of how incredibly dangerous certain K. pneumoniae strains can be, especially for people whose immune systems are weakened, like those with DKA, leading to incredibly fast and severe brain infections. Getting a quick diagnosis through scans and starting strong, targeted antibiotics are vital, but even then, the outlook for such widespread infections remains grim.

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