Klebsiella pneumoniae Necrotizing Fasciitis Associated with Diabetes and Liver Cirrhosis

Abstract

Sir —We read with interest the two articles in Clinical Infectious Diseases on the association of necrotizing fasciitis and Klebsiella pneumoniae liver abscess by Hu et al. [ 1 ] and Dylewski and Dylewski [ 2 ]. Although K. pneumoniae is a common co-pathogen in patients with polymicrobial necrotizing fasciitis, the bacterium is rarely the sole cause of this serous soft tissue infection [ 3 ]. As was pointed out by Hu et al. [ 1 ], all 4 patients who had liver abscess and fasciitis also had diabetes. Therefore, an awareness of the spectrum of underlying diseases in association with monomicrobial klebsiella fasciitis is important. We describe a case of K. pneumoniae necrotizing fasciitis and spontaneous bacterial peritonitis in a patient with diabetes and cirrhosis.