SEVERE KLEBSIELLA PNEUMONIA MIMICKING MIDDLE EAST RESPIRATORY SYNDROME IN A DIABETIC MALE RETURNING FROM SAUDI ARABIA

Abstract

A 35 year old diabetic male returned from Riyadh, KSA (April 2014) with historyof a recent upper respiratory febrile illness followed by intractable dyspnea andbilateral crackles on chest examination. His chest radiology revealed diffusebilateral alveolar shadowing and blood gas analysis was consistent with acuterespiratory failure in association with deranged liver function tests. Meeting allthe clinical criteria, he was managed in strict isolation with precautions as hewas a high suspect ‘patient under investigation’ (WHO/CDC)1 for Middle EastRespiratory Syndrome (MERS) versus an acute respiratory viral infection likeswine or human influenza or a disseminated bacterial pneumonia. His bronchoalveolarlavage (BAL) specimen along with nasopharyngeal swabs for MiddleEast Respiratory Syndrome corona virus (MERS Co-V) RT PCR, H1N1 andH5N1 influenza viruses were negative but growth of Klebsiella Pneumoniae onculture was positive. Treatment with appropriate antibiotic lead to completeclinical, biochemical, physiological and radiological recovery.