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Sticky Business: a syndrome of mucoid bacterial spread
  1. McKinsey M Pillsbury1,
  2. Rabih M Geha4 and
  3. Randall S Edson2
  1. 1 School of Medicine, University of California San Francisco, San Francisco, California, USA
  2. 2 Division of Infectious Diseases, California Pacific Medical Center, San Francisco, California, USA
  3. 4 Department of Medicine, University of California San Francisco, San Francisco, CA, USA
  1. Correspondence to McKinsey M Pillsbury, max.pillsbury{at}


A 70-year-old man presented with acute wrist pain concerning for septic arthritis. Shortly thereafter, he developed acute monocular vision loss and was diagnosed with endogenous endophthalmitis. Subsequent imaging revealed numerous visceral abscesses and a mycotic abdominal aortic aneurysm. Cultures, in conjunction with the clinical syndrome, were strongly suggestive of hypervirulent Klebsiella pneumoniae syndrome (hvKP). hvKP syndrome may present with multiple sites of infection or subsequent metastatic spread may develop; the liver, lungs, central nervous system and eye are most commonly involved. Prompt source control and intravenous antibiotic therapy leads to a cure in the majority of patients. This case highlights the risk factors, presentation, management and prognosis of this disease as well as its increasing incidence in North America and Europe.

  • infection (gastroenterology)
  • general practice / family medicine
  • infectious diseases

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  • Contributors RMG and MP collaborated on the case report and discussion section. RSE provided editorial and infectious diseases input in the preparation of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.