Cause:Klebsiella pneumoniae(enterobacteriaceae)

Fecal contamination usually; a normal inhabitant of large bowel and often in upper respiratory tract too; significant cause of central line infections

1% of all pneumonias; increased incidence in males >40 yr

Sx:Brown-red, thick ("currant jelly") sputum; fever, chills; pleurisy

Si:Fever; consolidation si's, often much less impressive than xray

Rapidly progressive; 25-50% mortality

Empyema; multiple drug resistance acquisition in hospital

Lab:

Bact:Gram stain shows gram-neg rods w capsule

Hem:Wbc may be low

Xray:Chest consolidations may be convex, "swollen lobar consolidation"

Rx:Gentamicin + cephalosporin, fluoroquinolone, or 3rd-generation cephalosporin until know sensitivities