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KMID : 0988920150130010085
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Intestinal Research
2015 Volume.13 No. 1 p.85 ~ p.89
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Perianal Abscess and Proctitis by Klebsiella pneumoniae
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Jeong Woo-Shin
Choi Sung-Youn
Jeong Eun-Haeng
Bang Ki-Bae
Park Seung-Sik
Lee Dae-Sung
Park Dong-Il
Jung Yoon-Suk
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Abstract
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Klebsiella pneumoniae (K. pneumoniae) can at times cause invasive infections, especially in patients with diabetes mellitus and a history of alcohol abuse. A 61-year-old man with diabetes mellitus and a history of alcohol abuse presented with ab-dominal and anal pain for two weeks. After admission, he underwent sigmoid￢oscopy, which revealed multiple ulcerations with yellowish exudate in the rectum and sigmoid colon. The patient was treated with ciprofloxacin and metronidazole. After one week, follow up sigmoidoscopy was performed owing to sustained fever and diarrhea. The lesions were aggravated and seemed webbed in appearance because of damage to the rectal mucosa. Abdominal computed tomography and rectal mag-netic resonance imaging were performed, and showed a perianal and perirectal abscess. The patient underwent laparoscopic sigmoid colostomy and perirectal abscess incision and drainage. Extended-spectrum beta-lactamase-producing K. pneumoni-ae was identified in pus culture. The antibiotics were switched to ertapenem. He improved after surgery and was discharged. K. pneumoniae can cause rapid invasive infection in patients with diabetes and a his￢tory of alcohol abuse. We report the first rare case of proctitis and perianal abscess caused by invasive K. pneumoniae infection. (Intest Res 2015;13:85-89)
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KEYWORD
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Klebsiella pneumoniae, Proctitis, Perianal abscess, Diabetes mellitus, Alcoholism
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