Abstract
Infections remain a dreadful complication after solid organ transplantation. Almost all microorganisms could cause this complication, including unusual ones. We report a 73-year-old patient, with a history of kidney transplant for 38 years on minimum immunosuppression, who presented with high-grade fever and gastrointestinal symptoms. Klebsiella ozaenae was isolated from blood cultures. She had a prompt response to antibiotics and recovered completely in a short period. Subsequent evaluation of her nasal cavity and sinuses did not show any abnormalities. Klebsiella ozaenae is primarily a colonizer of the oral and nasopharyngeal mucosa, which does not usually cause severe infections. Only 12 cases of Klebsiella ozaenae bacteremia have been reported, none of them in the context of solid organ transplant recipient.
Highlights
Infections are among the commonest causes of morbidity and mortality in solid organ transplant (SOT) recipients and are the second most cause of death in patients dying with functioning allografts [1]
We present the first case of K. ozaenae bacteremia in a SOT recipient
K. ozaenae is a gramnegative, nonmotile, aerobic, encapsulated rod bacterium. It is distinguished from K. pneumoniae subsp. pneumoniae by a negative reaction to Voges-Proskauer and malonate tests [6]
Summary
Infections are among the commonest causes of morbidity and mortality in solid organ transplant (SOT) recipients and are the second most cause of death in patients dying with functioning allografts [1]. Potential pathogens in this group of patients are diverse, ranging from common pathogens, like community-acquired bacteria and viruses to uncommon opportunistic pathogens that cause infections of clinical significance only in immunocompromised hosts [2]. It is more difficult to recognize infection in such patients than it is in persons with normal immune system, as inflammatory responses associated with microbial invasion are impaired by immunosuppressive therapy, which results in diminished symptoms and muted clinical and radiologic findings, and thereby delaying diagnosis. We present the first case of K. ozaenae bacteremia in a SOT recipient
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