Síndrome invasivo por Klebsiella pneumoniae hipervirulenta multidrogoresistente, recaída mortal después de tratamiento efectivo: un enemigo para nunca olvidar. Reporte de caso y revisión de la literature

Invasive syndrome caused by hypervirulent Klebsiella pneumoniae represents a diagnostic and therapeutic challenge, its incidence has increased, even outside Asia. It is usually a multisensitive microorganism but its ability to capture genetic material allows it to express resistance mechanisms, making it difficult to eradicate and more severe infections. Uncontrolled diabetes mellitus increases the rate of metastatic infection. Management is based on early clinical suspicion, a multidisciplinary approach, and antibiotic therapy plus drainage of infectious foci. We present a case of hypervirulent Klebsiella pneumoniae infection that produces extended-spectrum beta-lactamases (esbl) in a woman with a history of uncontrolled diabetes mellitus who presented an initially unrecognized infectious relapse with fatal outcome. Its epidemiology, pathogenesis, clinical presentation, diagnostic and therapeutic approach are described in order to provide the medical community with tools for timely management of the index case, and early diagnosis of a possible infectious relapse, focused on reducing high morbidity and mortality and severe sequelae from this disease.