AUTHOR=Li Junqing , Yang Zhuo , Wang Kai , Zha Bingbing , Du Yong , Shi Jindong , Jie Zhijun , Ding Heyuan 

TITLE=Syndrome of inappropriate antidiuretic hormone secretion following extensively drug-resistant Klebsiella pneumoniae associated with complicated urinary tract infection: a case report

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1574251

DOI=10.3389/fmed.2025.1574251

ISSN=2296-858X

ABSTRACT=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.