Kluyvera cryocrescens finger infection: case report and review of eighteen Kluyvera infections in human beings.

Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.

Kluyvera cryocrescens finger infection: case report and review of eighteen Kluyvera infections in human beings.

Diagn Microbiol Infect Dis. 1998 Nov;32(3):237-41. Unique Identifier : AIDSLINE MED/99100580
West BC; Vijayan H; Shekar R; Department of Medicine, Meridia Huron Hospital, Cleveland, Ohio; 44112, USA.

Abstract: We report a case of soft tissue infection with Kluyvera cryocrescens and a critical review of Kluyvera infections. A 31-year-old diabetic man used a new chemical for stripping the floor with his bare hands. Two days later he developed a blister on a finger which progressed to tenosynovitis in spite of intravenous nafcillin therapy. After 11 days culture and sensitivity results dictated treatment with intravenous ticarcillin/clavulanic acid. The wound was debrided twice, and later a skin flap was done. Wound cultures became sterile after 7 days of treatment with ticarcillin/clavulanic acid, and he recovered. This case represents the fourth clinical infection with K. cryocrescens and the eighteenth of Kluyvera to be reported. Four others were K. ascorbata, and the remaining ten Kluyvera infections in humans were not identified beyond genus. Our case and review of the 17 previous cases emphasize that while Kluyvera rarely cause disease, these opportunistic Gram-negative bacilli may be virulent in a variety of sites under as yet poorly defined host conditions. Sites of infection varied, but the brain and meninges were not among them. Two patients had diabetes mellitus, none had AIDS, and four died. Once shown clinically to be the cause of an infection, Kluyvera deserve aggressive treatment which acknowledges their ampicillin resistance.

Keywords: JOURNAL ARTICLE REVIEW REVIEW OF REPORTED CASES Adult Antibiotics, Combined/PHARMACOLOGY/THERAPEUTIC USE Case Report Clavulanic Acids/PHARMACOLOGY/THERAPEUTIC USE Debridement Diabetes Mellitus, Insulin-Dependent/COMPLICATIONS Enterobacteriaceae/DRUG EFFECTS/ISOLATION & PURIF/*PATHOGENICITY Enterobacteriaceae Infections/*DIAGNOSIS/DRUG THERAPY/SURGERY Fingers/*MICROBIOLOGY Human Male Nafcillin/PHARMACOLOGY/THERAPEUTIC USE Penicillins/PHARMACOLOGY/THERAPEUTIC USE Support, Non-U.S. Gov't Tenosynovitis/*DIAGNOSIS/DRUG THERAPY/SURGERY Ticarcillin/PHARMACOLOGY/THERAPEUTIC USE
990630
A9960940

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