{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T18:25:37Z","timestamp":1770056737599,"version":"3.49.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    We report a case of necrotizing pneumonia caused by hypervirulent\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    in an athletic, 54-year-old apnea diver. Since hypervirulent\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    strains prevail in Southeast Asia and are mainly associated with \u201cinvasive liver abscess syndrome\u201d, we considered and tested for hypervirulence only when the necrotizing pneumonia turned out to be refractory to initial antibiotic treatment. Although the hypervirulent\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    strain in our patient did not show multi-drug resistance, a total of 6 months of high-dose antibiotic therapy was necessary to cure the infection.\n                  <\/jats:p>","DOI":"10.1007\/s15010-025-02617-6","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:47:08Z","timestamp":1753868828000},"page":"521-526","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An unusual case of necrotizing pneumonia in a healthy apnea diver"],"prefix":"10.1007","volume":"54","author":[{"given":"Christian","family":"Beyer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rayya","family":"Alsalameh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Bogdan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marion","family":"Ganslmayer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus F.","family":"Neurath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Strau\u00df","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"F\u00fcrst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"issue":"3","key":"2617_CR1","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1111\/joim.13007","volume":"287","author":"JE Choby","year":"2020","unstructured":"Choby JE, Howard-Anderson J, Weiss DS. Hypervirulent Klebsiella pneumoniae - clinical and molecular perspectives. J Intern Med. 2020;287(3):283\u2013300. https:\/\/doi.org\/10.1111\/joim.13007","journal-title":"J Intern Med"},{"issue":"4","key":"2617_CR2","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1556\/030.2023.02186","volume":"70","author":"B Kocsis","year":"2023","unstructured":"Kocsis B. Hypervirulent Klebsiella pneumoniae: an update on epidemiology, detection and antibiotic resistance. Acta Microbiol Immunol Hung. 2023;70(4):278\u201387. https:\/\/doi.org\/10.1556\/030.2023.02186","journal-title":"Acta Microbiol Immunol Hung"},{"key":"2617_CR3","doi-asserted-by":"publisher","unstructured":"Russo TA, Marr CM. Hypervirulent Klebsiella pneumoniae. Clin Microbiol Rev. 2019;32(3). https:\/\/doi.org\/10.1128\/CMR.00001-19","DOI":"10.1128\/CMR.00001-19"},{"key":"2617_CR4","doi-asserted-by":"publisher","first-page":"642484","DOI":"10.3389\/fmicb.2021.642484","volume":"12","author":"J Zhu","year":"2021","unstructured":"Zhu J, Wang T, Chen L, Du H. Virulence factors in hypervirulent Klebsiella pneumoniae. Front Microbiol. 2021;12:642484. https:\/\/doi.org\/10.3389\/fmicb.2021.642484","journal-title":"Front Microbiol"},{"issue":"11","key":"2617_CR5","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1016\/S1473-3099(12)70205-0","volume":"12","author":"LK Siu","year":"2012","unstructured":"Siu LK, Yeh KM, Lin JC, Fung CP, Chang FY. Klebsiella pneumoniae liver abscess: a new invasive syndrome. Lancet Infect Dis. 2012;12(11):881\u20137. https:\/\/doi.org\/10.1016\/S1473-3099(12)70205-0","journal-title":"Lancet Infect Dis"},{"issue":"1","key":"2617_CR6","doi-asserted-by":"publisher","first-page":"2114739","DOI":"10.1080\/19490976.2022.2114739","volume":"14","author":"J Yang","year":"2022","unstructured":"Yang J, Li Y, Tang N, Li J, Zhou J, Lu S, et al. The human gut serves as a reservoir of hypervirulent Klebsiella pneumoniae. Gut Microbes. 2022;14(1):2114739. https:\/\/doi.org\/10.1080\/19490976.2022.2114739","journal-title":"Gut Microbes"},{"issue":"9","key":"2617_CR7","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1056\/NEJMicm2101602","volume":"385","author":"Q Zou","year":"2021","unstructured":"Zou Q, Li Y. Hypervirulent Klebsiella pneumoniae. N Engl J Med. 2021;385(9):833. https:\/\/doi.org\/10.1056\/NEJMicm2101602","journal-title":"N Engl J Med"},{"key":"2617_CR8","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.nmni.2017.02.006","volume":"17","author":"C Pichler","year":"2017","unstructured":"Pichler C, Buchsel M, Rossen JW, Vavra M, Reuter S, Kern WV, et al. First report of invasive liver abscess syndrome with endophthalmitis caused by a K2 serotype ST2398 hypervirulent Klebsiella pneumoniae in germany, 2016. New Microbes New Infect. 2017;17:77\u201380. https:\/\/doi.org\/10.1016\/j.nmni.2017.02.006","journal-title":"New Microbes New Infect"},{"key":"2617_CR9","doi-asserted-by":"publisher","unstructured":"Serban D, Popa Cherecheanu A, Dascalu AM, Socea B, Vancea G, Stana D, et al. Hypervirulent Klebsiella pneumoniae endogenous Endophthalmitis-A global emerging disease. Life (Basel). 2021;11(7). https:\/\/doi.org\/10.3390\/life11070676","DOI":"10.3390\/life11070676"},{"issue":"1","key":"2617_CR10","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1186\/s12879-023-08383-w","volume":"23","author":"Y Chang","year":"2023","unstructured":"Chang Y, Chen JH, Chen WL, Chung JY. Klebsiella pneumoniae invasive syndrome with liver abscess and purulent meningitis presenting as acute hemiplegia: a case report. BMC Infect Dis. 2023;23(1):397. https:\/\/doi.org\/10.1186\/s12879-023-08383-w","journal-title":"BMC Infect Dis"},{"issue":"3","key":"2617_CR11","doi-asserted-by":"publisher","first-page":"000800","DOI":"10.12890\/2018_000800","volume":"5","author":"V Evangelista","year":"2018","unstructured":"Evangelista V, Goncalves CV, Almeida R, Henriques C, Baptista AM, da Graca JP, et al. Klebsiella pneumoniae invasive syndrome. Eur J Case Rep Intern Med. 2018;5(3):000800. https:\/\/doi.org\/10.12890\/2018_000800","journal-title":"Eur J Case Rep Intern Med"},{"issue":"8","key":"2617_CR12","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1099\/jmm.0.000788","volume":"67","author":"C Rafat","year":"2018","unstructured":"Rafat C, Messika J, Barnaud G, Dufour N, Magdoud F, Billard-Pomares T, et al. Hypervirulent Klebsiella pneumoniae, a 5-year study in a French ICU. J Med Microbiol. 2018;67(8):1083\u20139. https:\/\/doi.org\/10.1099\/jmm.0.000788","journal-title":"J Med Microbiol"},{"issue":"1","key":"2617_CR13","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/S1473-3099(17)30489-9","volume":"18","author":"D Gu","year":"2018","unstructured":"Gu D, Dong N, Zheng Z, Lin D, Huang M, Wang L, et al. A fatal outbreak of ST11 carbapenem-resistant hypervirulent Klebsiella pneumoniae in a Chinese hospital: a molecular epidemiological study. Lancet Infect Dis. 2018;18(1):37\u201346. https:\/\/doi.org\/10.1016\/S1473-3099(17)30489-9","journal-title":"Lancet Infect Dis"},{"issue":"2","key":"2617_CR14","doi-asserted-by":"publisher","first-page":"108875","DOI":"10.1016\/j.isci.2024.108875","volume":"27","author":"TH Teo","year":"2024","unstructured":"Teo TH, Ayuni NN, Yin M, Liew JH, Chen JQ, Kurepina N, et al. Differential mucosal tropism and dissemination of classical and hypervirulent Klebsiella pneumoniae infection. iScience. 2024;27(2):108875. https:\/\/doi.org\/10.1016\/j.isci.2024.108875","journal-title":"iScience"},{"key":"2617_CR15","first-page":"A3079","volume":"205","author":"O Walsh SJ-P","year":"2022","unstructured":"Walsh SJ-P O, Rowe N, Panayi J. Diving deep for a diagnosis: A case of Mycobacterium marinum (abstract). Am J Respir Crit Care Med. 2022;205:A3079.","journal-title":"Am J Respir Crit Care Med"},{"key":"2617_CR16","doi-asserted-by":"publisher","first-page":"28","DOI":"10.3389\/fmed.2016.00028","volume":"3","author":"T Kishaba","year":"2016","unstructured":"Kishaba T. Community-Acquired pneumonia caused by Mycoplasma pneumoniae: how physical and radiological examination contribute to successful diagnosis. Front Med (Lausanne). 2016;3:28. https:\/\/doi.org\/10.3389\/fmed.2016.00028","journal-title":"Front Med (Lausanne)"},{"issue":"8","key":"2617_CR17","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1016\/j.rmed.2013.03.016","volume":"107","author":"G Tunnicliffe","year":"2013","unstructured":"Tunnicliffe G, Schomberg L, Walsh S, Tinwell B, Harrison T, Chua F. Airway and parenchymal manifestations of pulmonary aspergillosis. Respir Med. 2013;107(8):1113\u201323. https:\/\/doi.org\/10.1016\/j.rmed.2013.03.016","journal-title":"Respir Med"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-025-02617-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-025-02617-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-025-02617-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T08:39:50Z","timestamp":1770021590000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-025-02617-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,30]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["2617"],"URL":"https:\/\/doi.org\/10.1007\/s15010-025-02617-6","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,30]]},"assertion":[{"value":"4 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable (case report).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The participant has consented to the submission of the case report to the journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}