Blood advances · 2026
Fiber intake associates with increased treatment response in patients with multiple myeloma along with changes in gut microbiome.
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Sester Lilli S, Galeeva Iuliia, de Castilhos Juliana, Borisov Vadim, Gambihler Anna K, Kilian Michael, Vonhören David, Friedrich Mirco J, Poschet Gernot, Steiger Simon, Chechenina Anna, Lettau Konstanze, Kohlberger Chris P, Prokoph Nina, Frenking Jan, John Lukas, Huhn Stefanie, Reichert Philipp, Mai Elias K, Rippe Karsten, Sauer Sandra, Müller-Tidow Carsten, Weinhold Niels, Platten Michael, Goldschmidt Hartmut, Raab Marc-Steffen, Stein-Thoeringer Christoph K
Аннотация
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.
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.