Management of carbapenem-resistant Klebsiella pneumoniae infection in a patient with diabetic foot ulcer and necrotizing soft tissue infection, bacteremia and lung infection: A case report

摘要

While many diabetic patients with foot infection were treated in our hospital every year, this was a unique case with such an exten- sive soft tissue infection and necrosis. The followings were key stra- tegies to treat this case. First, laboratory and _ radiological examinations including MRI of the infected leg were necessary. Sec- ond, aggressive debridement surgery and suction with negative pressure were crucial in that it could be helpful for wound healing and tissue repair. However, if the infection threat patient's life, amputation should be performed immediately. Third, appropriate application of antibiotics was crucial. Based on the result of bacte- rial culture with positive carbepenem-resistant Klabeslia pneumo- niae, polymyxin B in combination with tigecycline, imipenem, and isepamicin were used for 2 weeks for the patient in the current case report. Fourth, cooperation of specialists from various spe- cialties was crucial for the successful treatment of severe infection in the diabetic patients.” Close cooperation between Pulmonologist (mechanical ventilation), Endocrinologist, Nutritionist, Radiologist, and Sugeons played a key role in the successful management of the current case.