PMC8426520_01
(A) Thoracic CT scan showed hepatic cyst in S7 segment; (B) The string test prompted hypermucoviscosity phenotype.
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An ultrasound color doppler showed cavity effusion and synovial thickening in right knee joint, and thoracic CT showed pneumonia and hepatic cyst in S7 segment (Fig. 1A). On day 5, Blood culture was positive for Klebsiella pneumoniae, and microbiology laboratory tests (the string test in Fig. 1B) for hvKP turned out to be positive.
Body temperature and antibiotic therapy use during hospitalization. Body temperature: measured every 4 h; Antibiotic use: Piperacillin/tazobactam 4.5 g q8h (day1-4), Biapenem 0.3 g q6h (day 4-7) and vancomycin 1 g q12h (day 4-6 and day14-17), Meropenem 2 g q8h (day 7-25), Linezolid 0.6 g q12h (day 10-14), Voriconazole 0.4 g q12h (day 12-14), Rifampicin 0.6 g q12h (day 16-27).
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The patient improved clinically (Fig. 2) three days after changing the antimicrobials to meropenem and RFP.