Invasive Infection With Hypermucoviscous Klebsiella pneumoniae: Multiple Cases Presenting to a Single Emergency Department in the United States

A distinctive form of community-acquired invasive Klebsiella pneumoniae infection has been well described in Southeast Asia for more than 2 decades. The clinical syndrome includes liver abscess, bacteremia, and metastatic infection. It has recently been linked to a virulent hypermucoviscous K pneumoniae phenotype and to a specific genotype. As of 2008, there were only 2 published cases of invasive infection caused by this strain of K pneumoniae in the United States. We report 4 recent cases presenting to a single public hospital emergency department in northern California, which may signal the emergence of this clinical syndrome in North America.