Abstract
BackgroundKlebsiella oxytoca can cause various infectious complications in healthy as well as in immunocompromised individuals.Case PresentationsCase 1: A 49 year old female with multiple myeloma received an autologous hematopoietic stem cell transplant in October 2005. Eight days following her autograft she developed septic shock caused by Klebsiella oxytoca bacteremia which was successfully treated with intravenous meropenem and gentamicin. Case 2: A 29 year old female with sickle cell anemia and severe aplastic anemia underwent an allogeneic hematopoietic stem cell transplant in July 2005. Seven months following her unsuccessful allograft, she developed septic shock due to Klebsiella oxytoca bacteremia caused by a urinary tract infection. The septic episode was successfully managed with intravenous meropenem and gentamicin. Both patients were treated at King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia. To our knowledge, they are the first reports of Klebsiella oxytoca bacteremias and septic shocks in hematopoietic stem cell transplant recipients.ConclusionKlebsiella oxytoca should be considered as a possible cause of severe infections in recipients of various forms of hematopoietic stem cell transplantation. However, these infections may be complicated by bacteremias, septic shocks, systemic dysfunctions and even deaths if not managed promptly and appropriately.
Highlights
Klebsiella species are the second most frequent cause of gram-negative bacteremia [1]
Infections caused by K. oxytoca occur in healthy individuals, newborn babies and immunocompromised hosts such as patients with diabetes mellitus, solid tumours and leukemia [4,5,6,7,8,9,10,11,12,13]. These infections may be encountered in patients having: neurosurgical procedures, prostatectomies, colonoscopies, intravascular catheters, platelet transfusions, urinary tract infections and pre-existing viral or antibiotic induced colitis [4,5,6,7]
Bacteremia caused by K. oxytoca can be nosocomial or community-acquired [4,5,6,8,9,10,11,12,13,14]
Summary
K. oxytoca can cause serious infections, bacteremias and septic shocks in immunocompromised individuals including recipients of various forms of HSCT. Careful clinical assessment, taking enough investigations and administration of appropriate antimicrobial therapy are essential to control these infections and to prevent further complications. K.oxytoca: klebsiella oxytoca; MM: multiple myeloma; SAA: severe aplastic anemia; HSCT: hematopoietic stem cell transplantation
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