Case Report

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

Authors: Tami Brooks, MD, Sandor Feldman, MD

Abstract

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.

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References

1. Farmer JJIII, Fanning GR, Huntley-Carter GP, Holmes B, Hickman FW, Richard C, et al. Kluyvera, a new (redefined) genus in the family Enterobacteriaceae: Identification of Kluyvera ascorbata sp. nov. and Kluyvera cryocrescens sp. nov. in clinical specimens. J Clin Microbiol 1981; 13: 919–933.
 
2. West BC, Vijayan H, Shekar R. Kluyvera cryocrescens finger infection: Case report and review of eighteen Kluyvera infections in human beings. Diagn Microbiol Infect Dis 1998; 32: 237–241.
 
3. Balows A, Hausler WJ Jr, Herrmann KL, Isenberg HD, Shadomy HJ (eds). Manual of Clinical Microbiology. Washington, DC, American Society for Microbiology, 1991, ed 5, pp 376–377.
 
4. Dollberg S, Gandacu A, Klar A. Acute pyelonephritis due to a Kluyvera species in a child. Eur J Clin Microbiol Infect Dis 1990; 9: 281–283.
 
5. Yogev R, Kozlowski S. Peritonitis due to Kluyvera ascorbata: Case report and review. Rev Infect Dis 1990; 12: 399–402.
 
6. Wong VK. Broviac catheter infection with Kluyvera cryocrescens: A case report. J Clin Microbiol 1987; 25: 1115–1116.
 
7. Aevaliotis A, Belle AM, Chanione JP, et al. Kluyvera ascorbata isolated from a baby with diarrhea. Clin Microbiol Newsl 1985; 7: 51.
 
8. Tristram DA, Forbes BA. Kluyvera: A case report of urinary tract infection and sepsis. Pediatr Infect Dis J 1988; 7: 297–298.
 
9. Ortega Calvo M, Delgado Zamora R, Fernandez Arance P, Elgorriaga Guillen LJ, Del Valle Vazquez L, Gutierrez Caracuel J. Kluyvera cryocrescens: A positive urine culture in a young girl with persistent proteinuria [in Spanish]. Actas Urol Esp 1999; 23: 528–531.
 
10. Mermel LA, Farr BM, Sherertz RJ, Raad II, O'Grady N, Harris JS, et al. Guidelines for the management of intravascular catheter-related infections: Society for Healthcare Epidemiology of America. Clin Infect Dis 2001; 32: 1249–1272.
 
11. Johnson DC, Johnson FL, Goldman S. Preliminary results treating persistent central venous catheter infections with the antibiotic lock technique in pediatric patients. Pediatr Infect Dis J 1994; 13: 930–931.