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A Case of Esophageal Infectious Shock Precipitated by Klebsiella pneumoniae Acute Esophagitis: Presenting with Refractory Epigastric Pain
Asploro Journal of Biomedical and Clinical Case Reports
Author(s): Lipeng Liu1, Bin He1*, Pan Pan1
1Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
Corresponding Author: Bin He
Address: Department of Emergency Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Valley, Wuhou District, Chengdu 610041, Sichuan Province, China.
Received date: 02 July 2026; Accepted date: 14 July 2026; Published date: 21 July 2026
Citation: Liu L, He B, Pan P. A Case of Esophageal Infectious Shock Precipitated by Klebsiella pneumoniae Acute Esophagitis: Presenting with Refractory Epigastric Pain. Asp Biomed Clin Case Rep. 2026 Jul 21;9(2):135-40.
Copyright © 2026 Liu L, He B, Pan P. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.
Keywords: Acute Epigastric Pain, Esophageal Inflammation, Septic Shock, Next-Generation Sequencing (NGS)
Abstract
Background: Acute epigastric pain is a common emergency presentation, but infectious esophagitis as its etiology is rare and easily overlooked [1]. We report a rare case of Klebsiella pneumoniae infectious esophagitis presenting as refractory epigastric pain and rapidly progressing to septic shock.
Case Presentation: A 52-year-old man with uncontrolled diabetes presented with severe epigastric pain unresponsive to multiple analgesics. Computed tomography (CT) revealed diffuse esophageal wall thickening, and he rapidly deteriorated into septic shock, rendering endoscopy contraindicated. Blood next-generation sequencing (NGS) identified Klebsiella pneumoniae (resistant to third-generation cephalosporins), leading to targeted therapy with meropenem and continuous renal replacement therapy (CRRT). Subsequent endoscopy confirmed inflammatory esophageal swelling.
Conclusion: Refractory epigastric pain unresponsive to conventional analgesics should alert clinicians to severe atypical infections such as K. pneumoniae esophagitis, especially in immunocompromised patients. Early CT evaluation and NGS are crucial for rapid pathogen identification and targeted therapy to prevent fatal septic shock.