Klebsiella pneumoniae and Disseminated Intravascular Coagulation: A Comprehensive Review of Pathogenesis, Clinical Manifestations, and Management Strategies.

K. pneumoniae represents a significant opportunistic pathogen capable of causing life-threatening infections, particularly in immunocompromised and critically ill patients. Despite increasing reports of severe coagulopathy in K. pneumoniae sepsis, pathogen-specific mechanisms and tailored management strategies remain insufficiently characterized. This review aims to systematically examine the intricate relationship between K. pneumoniae infections and the development of DIC, a critical complication with high mortality rates, by integrating microbial virulence factors with the host's thrombo-inflammatory response. We explore the microbial virulence factors that contribute to disease pathogenesis, including capsular polysaccharides, lipopolysaccharides, siderophores, and various genetic determinants that enable immune evasion and systemic dissemination. The pathophysiological mechanisms linking K. pneumoniae sepsis to DIC are detailed, emphasizing the role of inflammatory cytokines, coagulation cascade activation, and endothelial dysfunction. Clinical manifestations, diagnostic challenges including a thorough overview of global diagnostic criteria, and current management strategies are discussed, highlighting the importance of early recognition and targeted intervention. In conclusion, this review underscores that DIC in K. pneumoniae sepsis results from a synergistic interaction between specific bacterial virulence factors (eg, LPS, capsule, siderophores) and a dysregulated host thrombo-inflammatory response, advocating for a preemptive, multimodal management strategy that combines rapid antimicrobial therapy with early recognition of coagulopathy to improve patient outcomes.