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已发表论文
肺炎克雷伯菌关节腔内注射后所致坏死性软组织感染：1 例报告并文献复习
Authors Wang X , Chen J, Gui S, Zhang X, Qian J, Xu X, Fan Z
Received 14 September 2025
Accepted for publication 15 December 2025
Published 8 January 2026 Volume 2026:19 566831
DOI https://doi.org/10.2147/IDR.S566831
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Hemant Joshi
Xia Wang, Jie Chen, Shenghao Gui, Xiang Zhang, Juanqin Qian, Xia Xu, Zhiyuan Fan
Department of Emergency Medicine, Tongxiang First People’s Hospital, Jiaxing, Zhejiang, People’s Republic of China
Correspondence: Zhiyuan Fan, Department of Emergency Medicine, Tongxiang First People’s Hospital, Jiaxing, Zhejiang, People’s Republic of China, Email fanzhiyuan19880916@126.com
Background: Necrotizing soft tissue infection is a fulminant, life-threatening condition causing sepsis along with multiorgan failure, with Klebsiella pneumoniae -induced cases rising, especially in diabetics. Intra-articular injection-related Klebsiella pneumoniae -induced necrotizing soft tissue infection has not been reported previously; only 35 Klebsiella pneumoniae -induced extremity necrotizing soft tissue infection cases exist in English literature.
Case Presentation: A 67-year-old diabetic woman with hypertension developed right lower extremity Klebsiella pneumoniae -induced necrotizing soft tissue infection post-intra-articular glucocorticoid/anesthetic injection. She had swelling, pain, confusion; computed tomography showed soft tissue swelling/gas, blood culture confirmed Klebsiella pneumoniae, Laboratory Risk Indicator for Necrotizing Fasciitis score was 9 (out of 13). Family refused debridement; despite antibiotics, Continuous Renal Replacement Therapy, and glucose control, she died of multiorgan failure 18 hours post-admission.
Conclusion: Klebsiella pneumoniae -induced cases rising, especially in diabetics is highly lethal (38.9% mortality in 36 reviewed cases), with diabetes as the main risk factor. Early diagnosis (computed tomography, Laboratory Risk Indicator for Necrotizing Fasciitis) and aggressive debridement are critical. Intra-articular injection infection prevention and timely etiological exams are essential.
Keywords: intra-articular injection, diabetes mellitus, necrotizing soft tissue infection, Klebsiella pneumoniae
Department of Emergency Medicine, Tongxiang First People’s Hospital, Jiaxing, Zhejiang, People’s Republic of China
Correspondence: Zhiyuan Fan, Department of Emergency Medicine, Tongxiang First People’s Hospital, Jiaxing, Zhejiang, People’s Republic of China, Email fanzhiyuan19880916@126.com
Background: Necrotizing soft tissue infection is a fulminant, life-threatening condition causing sepsis along with multiorgan failure, with Klebsiella pneumoniae -induced cases rising, especially in diabetics. Intra-articular injection-related Klebsiella pneumoniae -induced necrotizing soft tissue infection has not been reported previously; only 35 Klebsiella pneumoniae -induced extremity necrotizing soft tissue infection cases exist in English literature.
Case Presentation: A 67-year-old diabetic woman with hypertension developed right lower extremity Klebsiella pneumoniae -induced necrotizing soft tissue infection post-intra-articular glucocorticoid/anesthetic injection. She had swelling, pain, confusion; computed tomography showed soft tissue swelling/gas, blood culture confirmed Klebsiella pneumoniae, Laboratory Risk Indicator for Necrotizing Fasciitis score was 9 (out of 13). Family refused debridement; despite antibiotics, Continuous Renal Replacement Therapy, and glucose control, she died of multiorgan failure 18 hours post-admission.
Conclusion: Klebsiella pneumoniae -induced cases rising, especially in diabetics is highly lethal (38.9% mortality in 36 reviewed cases), with diabetes as the main risk factor. Early diagnosis (computed tomography, Laboratory Risk Indicator for Necrotizing Fasciitis) and aggressive debridement are critical. Intra-articular injection infection prevention and timely etiological exams are essential.
Keywords: intra-articular injection, diabetes mellitus, necrotizing soft tissue infection, Klebsiella pneumoniae