Relapsing Klebsiella pneumoniae meningitis in a patient with COVID-19.

Klebsiella pneumoniae is a common cause of potentially life-threatening infection. This report describes a relapsing healthcare-associated Klebsiella pneumoniae meningitis in a 60-year-old patient who had SARS-CoV-2 infection. During their initial admission for COVID-19 pneumonitis and treatment with corticosteroids, the patient developed signs and symptoms suggestive of bacterial meningitis. Blood and cerebrospinal fluid cultures confirmed Klebsiella pneumoniae as the causative organism. The patient was treated with a prolonged course of high-dose meropenem and made an apparent recovery. Four days after hospital discharge, the patient re-presented critically unwell. Klebsiella pneumoniae was once again isolated from cerebrospinal fluid. During their second admission, the patient deteriorated despite antimicrobial treatment, and life-sustaining therapies were withdrawn. This case highlights that all COVID-19 patients receiving immunosuppressive therapy should be monitored for potential opportunistic infection. Prompt recognition and early antimicrobial therapy are key to improving patient outcomes.