AM Report Pearls: Sepsis Mimickers, Hypervirulent Klebs!

AM Report Pearls: Non-Infectious Sepsis Mimics

  • Massive tissue injury:
    • Polytrauma
    • Pulmonary embolism
    • Severe pancreatititis
    • Acute organ transplant rejection
    • Erythroderma
  • Metabolic causes:
    • Thyroid storm
    • Acute adrenal insufficiency
  • Iatrogenic causes:
    • Blood products
    • GCSF reaction
    • Anesthetic-related malignant hyperthermia
    • Neuroleptic malignant syndrome
    • DRESS
  • Malignancy related causes:
    • HLH
    • Tumor lysis syndrome

AM Report Pearls: Hypervirulent Klebsiella (Pearls from Jen Babik!)

  • Klebsiella pneumonia is an encapsulated GNR and the K antigen is the capsular polysaccharide
    • It has a mucoid appearance and one of the main determinants of virulence
  • Severe Klebsiella pneumonia can manifest in multiple organs – including PNA, UTI, meningitis, bactermia, liver abscess, endophthalmitis – in the words of HH – it can behave like Staph!
  • The hypermucoviscosity (HV) Phenotype is determined by the string teste. formation of viscous strings when a loop is used to stretch a colony from an agar tape https://www.youtube.com/watch?v=_LP5KoguPC0
  • This hypermucoviscosity phenotype has been seen more commonly in patients from East Asia esp Taiwan – DM is also a very common risk factor
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