Long DL, Wang YH, Wang JL, Mu SJ, Chen L, Shi XQ, Li JQ. Fatal community-acquired bloodstream infection caused by Klebsiella variicola: A case report. World J Clin Cases 2022; 10(8): 2474-2483 [PMID: 35434053 DOI: 10.12998/wjcc.v10.i8.2474]
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World J Clin Cases. Mar 16, 2022; 10(8): 2474-2483 Published online Mar 16, 2022. doi: 10.12998/wjcc.v10.i8.2474
Table 1 Liver and renal function results
Item
Result (1st)
Reference range
TBIL (μmol/L)
19.4
3.6-20.5
TP (μmol/L)
49.8
65-85
ALB (g/L)
31.4
40-55
ALT (U/L)
156
9-50
AST (U/L)
182
15-40
sCrea (μmol/L)
160
57-97
Urea (μmol/L)
12.40
3.1-8
GLU (mmol/L)
13.89
3.9-6.1
K+ (mmol/L)
3.22
3.5-5.5
UA (μmol/L)
591
210-420
Table 2 Clotting function parameters tested after referral
Item
Result
Reference range
3P
Negative
Negative
D-D (μg/mL)
60.75↑
0-1
FDP (μg/mL)
128.5↑
0-5
PT (s)
18.3↑
9.2-12.2
INR
1.59↑
0.8-1.2
APTT (s)
67.6↑
21.1-36.5
TT (s)
23.4↑
14-21
FBG (g/L)
22.58
1.8-3.5
Table 3 Inflammatory parameters
Item
Result
Reference range
WBC (× 109)
1.2
3.5-10
NEUT (× 109)
0.63
1.8-6.3
%NEUT
52.5
40-75
MONO (× 109)
0.05
0.1-0.6
%MONO
4.2
3-10
LYMBP (× 109)
0.39
1.1-3.2
%LYMBP
32.5
20-50
RBC (× 1012)
1.83
3.5-5.5
HGB (g/L)
52.0
114-163
%HCT
15.6
35-50
PLT (× 109)
10
125-350
CRP (mg/L)
230.33
0-5
PCT
> 100
0-0.046
Table 4 Results related to virus, mycobacteria, mycoplasma/chlamydia, and autoimmune disease
Item
Result
Reference
RSV-IGM
Negative
Negative
ADV-IGM
Negative
Negative
IFZA-IGM
Negative
Negative
IFZB-IGM
Negative
Negative
HPIVs-IGM
Negative
Negative
MP-IGM
Negative
Negative
CP-IGM
Negative
Negative
CBV-IGM
Negative
Negative
CAV-IGM
Negative
Negative
ECHO-IGM
Negative
Negative
LP-IGM
Negative
Negative
2019-nCoV
Negative
Negative
EB-DNA (copies/mL)
< 5E + 2
< 5E + 2
EB-DNA
Negative
Negative
CMVDNA DL (copies/mL)
< 5E + 2
< 5E + 2
CMV DNA DX
Negative
Negative
t1
Test method: Blotting
A-PR3
Negative
Negative
A-MP0
Negative
Negative
A-GBM
Negative
Negative
t2
Test method: Fluorescence
cANCA
Negative
Negative
pANCA
Negative
Negative
Table 5 Results of bacterial culture and drug sensitivity
Specimen
Blood
Equipment
Phoenix100
Items
Bacterial culture + antimicrobial susceptibility
Results
Klebsiella pneumoniae
Antibiotics
MIC
Result interpretation
Cutoff
Cefotaxime
S
S ≤ 1; R ≥ 4
Cotrimoxazole
≤ 20
S
S ≤ 2/38; R ≥ 4/76
Tigecycline
≤ 0.5
S
Levofloxacin
≤ 0.12
S
S ≤ 0.5; R ≥ 2
Amikacin
≤ 2
S
S ≤ 16; R ≥ 64
Imipenem
≤ 0.25
S
S ≤ 1; R ≥ 4
Er ertapenem
≤ 0.12
S
S ≤ 0.5; R ≥ 2
Cefepime
≤ 0.12
S
S ≤ 2; R ≥ 16
Ce foperazone/sulbactam
≤ 8
S
S ≤ 16; R≥ 64
Ceftriaxone
≤ 0.25
S
S ≤ 1; R ≥ 4
Ceftazidime
≤ 0.12
S
S ≤ 4; R ≥ 16
Cefoxitin
≤ 4
S
S ≤ 8; R ≥ 32
Cefuroxime axetil
4
S
Cefuroxime
4
S
S ≤ 4; R ≥ 32
Piperacillin/tatabatam
≤ 4
S
S ≤ 16/4; R ≥ 128/4
Amoxicillin/clavulanate
≤ 2
S
S ≤ 8/4; R ≥ 32/16
ESBL
Neg
-
Table 6 PMseq-DNA Pro high throughput gene detection of blood sample
Type
Genus (number of sequences)
Species (number of sequences)
G
Klebsiella
68405
Klebsiella pneumoniae
243747
Klebsiella variicola
543
Citation: Long DL, Wang YH, Wang JL, Mu SJ, Chen L, Shi XQ, Li JQ. Fatal community-acquired bloodstream infection caused by Klebsiella variicola: A case report. World J Clin Cases 2022; 10(8): 2474-2483