CASE REPORT article
Front. Med.
Sec. Geriatric Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1574251
Syndrome of inappropriate antidiuresis following extensively drug-resistant Klebsiella pneumoniae associated with complicated urinary tract infection: A case report
Provisionally accepted
- 1Fudan University, Shanghai, China
- 2Shanghai Fifth People's Hospital, Fudan University, Shanghai, Shanghai Municipality, China
- 3Luxi County People's Hospital, Honghe Hani and Yi Autonomous Prefecture, China
- 4Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, Shanghai Municipality, China
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Hyponatremia is strongly associated with syndrome of inappropriate antidiuretic hormone secretion (SIADH). We present an 82-year-old male with refractory hyponatremia unresponsive to the discontinuation of hydrochlorothiazide and comprehensive treatment (fluid restriction, sodium supplementation, and tolvaptan).Two consecutive urine cultures identified extensively drug-resistant Klebsiella pneumoniae (XDRKP). After tigecycline treatment, serum sodium returned to normal and remained stable during one-year follow-up. This case suggests a close relationship between XDRKP infection and SIADH, highlighting the need to evaluate drug-resistant pathogens in patients with refractory hyponatremia and the importance of antimicrobial therapy in the management of electrolyte disorders secondary to drug-resistant urinary tract infections.
Keywords: SIADH, Hyponatremia, Extensively drug-resistant, Klebsiella pneumoniae, Urinary tract infection
Received: 10 Feb 2025; Accepted: 10 Jun 2025.
Copyright: © 2025 Li, Yang, Wang, Zha, Du, Shi, Jie and Ding. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhijun Jie, Shanghai Fifth People's Hospital, Fudan University, Shanghai, Shanghai Municipality, China
Heyuan Ding, Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, Shanghai Municipality, China
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