This is an example of progressive KPP due to septic pulmonary emboli and infarction or subsequent necrotizing infection. Klebsiella can cause soft-tissue infections via a skin breach and in this case, septic thrombophlebitis developed. There was a dramatic onset of respiratory disease with rapid progression leading to acute respiratory distress syndrome (ARDS) and pulmonary edema despite treatment.

Diabetics are at risk of Klebsiella infection. Importantly hypervirulent strains can present with unusual manifestations such as soft-tissue abscess and are increasingly gaining antibiotic resistance. Drainage of abscesses improves prognosis.