A case of klebsiella ornithinolytica bacteremia / 대한내과학회지

ABSTRACT

Klebsiella ornithinolytica is a very rare Klebsiella species isolated from human. Human strains have been isolated mainly from respiratory secretions, wounds and urine. The clinical features and pathogenic role of human disease with K. ornithinolytica is unknown. We describe a case of K. ornithinolytica bacteremia which developed in a 45-year-old man with acute cholangitis by common bile duct stones. In this case, K. ornithinolytica was sensitive to beta-lactamase inhibitor, all tested cephalosporins, aminoglycosides, quinolones, trimethoprim/sulfameth- oxazole but resistant to ampicillin. After intravenous therapy with cefotaxime, follow up blood culture showed no further growth of K. ornithinolytica. Later, extended-spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae and Escherichia coli was cultured from bile, so the antibiotics was switched to meropenem. Common bile duct stones was removed by percutaneous transhepatic cholangioscopy (PTCS) and the patient recovered fully without any complication.