Talha Mahmud, Abdul Hafeez, Muhammad Saqib, Adnan Najab, Muhammad Ramzan.
Severe klebsiella pneumonia mimicking middle east respiratory syndrome in a diabetic male returning from Saudi Arabia.
Pak J Chest Med Jan ;20(3):99-103.

A 35 year old diabetic male returned from Riyadh, KSA (April 2014) with history of a recent upper respiratory febrile illness followed by intractable dyspnea and bilateral crackles on chest examination. His chest radiology revealed diffuse bilateral alveolar shadowing and blood gas analysis was consistent with acute respiratory failure in association with deranged liver function tests. Meeting all the clinical criteria, he was managed in strict isolation with precautions as he was a high suspect ‘patient under investigation’ (WHO/CDC)1 for Middle East Respiratory Syndrome (MERS) versus an acute respiratory viral infection like swine or human influenza or a disseminated bacterial pneumonia. His bronchoalveolar lavage (BAL) specimen along with nasopharyngeal swabs for Middle East Respiratory Syndrome corona virus (MERS Co-V) RT PCR, H1N1 and H5N1 influenza viruses were negative but growth of Klebsiella Pneumoniae on culture was positive. Treatment with appropriate antibiotic lead to complete clinical, biochemical, physiological and radiological recovery.

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