Case Report: A rare case of oesophageal cellulitis caused by Klebsiella pneumoniae: diagnosis, management, and literature review.

Oesophageal cellulitis caused by Klebsiella pneumoniae infection is extremely rare and is often missed because of its atypical symptoms and endoscopic presentation. In this article, a case of a 56-year-old male with poorly controlled diabetes mellitus who presented with chest pain, acid reflux, nausea, vomiting, and weight loss is reported. Imaging revealed progressive, diffuse oedema and thickening of the oesophageal wall, followed by submucosal stratification, fistula formation, and extraluminal gas bubbles. Endoscopic examination revealed progression from erosions in the upper oesophagus to multiple ulcers, fistulae, and intramural abscess formation in the middle and lower oesophagus. Both secretions and tissue cultures confirmed K. pneumoniae infection. Following comprehensive treatment, including acid suppression, the administration of effective antibiotics, mucosal repair, nutritional support, and appropriate endoscopic debridement to facilitate drainage, the patient's symptoms and endoscopic findings significantly improved, and the development of severe complications, such as oesophagotracheal or oesophagomediastinal fistulae, was avoided. This case highlights the need to consider bacterial infection in the differential diagnosis of atypical oesophageal lesions in immunocompromised hosts and emphasises the importance of pathogen-directed, precise anti-infective therapy.