Central Venous Catheter Infection in a Child: Case Report and Review of Kluyvera Infection in Children

Tami Brooks, MD, Sandor Feldman, MD

Disclosures

South Med J. 2003;96(2) 

In This Article

Abstract and Introduction

Kluyvera is an opportunistic pathogen that can occur in immunosuppressed as well as immunocompetent hosts. We report a case of Kluyvera species infection involving a central venous catheter, and we review the literature on Kluyvera infections in children. Our case demonstrates that removal of the central venous catheter was necessary to eradicate the infection and hasten the resolution of refractory neutropenia. The spectrum of disease due to Kluyvera infection in children includes central venous catheter infection and/or sepsis, urinary tract infection, enteritis, and, in one instance, fatal peritonitis. It is clear on the basis of our case report that uncommon, opportunistic organisms such as Kluyvera can be significant pathogens.

Kluyvera, a genus in the family Enterobacteriaceae, is a Gram-negative bacillus previously described as an opportunistic pathogen. Kluyvera has been isolated from a variety of human specimens (most commonly sputum, where it is unlikely to be clinically significant). Kluyvera has been found in food, water, soil, sewage, and hospital environments. After Farmer et al's[1] redefinition of the Kluyvera genus in 1981, reports of its isolation in other clinical specimens began to appear. In 1998, West et al[2] reviewed 18 cases of Kluyvera infection in humans (primarily in adults). We report a case of this disease in a child and review the literature regarding Kluyvera infection exclusively in children. Our case demonstrates that opportunistic organisms such as Kluyvera species can infect a central venous catheter in an immunosuppressed patient and cause significant illness.

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