Fatal sepsis caused by mixed bloodstream infection of Klebsiella pneumoniae and klebsiella variicola in community: a case report in China

Abstract

Objective: We report a patient died within 72 hours after community-acquired bloodstream infection caused by klebsiella pneumoniae and klebsiella variicola in China. Measurements: A 52-years male was admitted to hospital due to unknown high fever, cough and headache. He had the medical history of diabetes and Gout. Patient’s condition deteriorated rapidly after symptom onset. Anti-viral, anti-positive coccal treatments combined with the anti-fungal therapy were administered before examination results were released. The laboratory examinations including the blood routine, culture of blood sample, chest CT and abdominal ultrasonography were tested. Additionally, the PMseq-DNA Pro High throughput gene detection was used to screen the source related to fungi, bacteria, mycobacteria, mycoplasma/chlamydia, parasites and viruses. Main results: All examinations excluded the viruses, fungi, mycoplasma/chlamydia infection and parasitic infection. Treatments including anti-fungi, anti-virus and antibacterial drug across a broad-spectrum failed to improve patient’s symptoms. Patient’s condition worsened and rapidly entered sepsis and subsequent sepsis shock, with death occurring 72 hours after symptom onset. The classic bacterial culture only revealed the klebsiella pneumonia infection, and klebsiella is sensitive to antibiotics used for this patient. While PMseq-DNA Pro high throughput gene detection of the blood sample was acquired one day after the patient died, which showed the mixed infection of klebsiella pneumoniae and klebsiella variicola. Conclusion: It is a very rare case reported previously that patient died from bacterial infection within short period of time. Klebsiella variicola could contribute to illness rapid progression in this case. Classic method is limited in guiding the anti-infection therapy for complex cases, early genetic detection should be recommended in the diagnosis and management of complex infection. and the manifestations of severe infection.