Klebsiella oxytoca bacteremia causing septic shock in recipients of hematopoietic stem cell transplant: Two case reports

BACKGROUND: Klebsiella oxytoca can cause various infectious complications in healthy as well as in immunocompromised individuals. CASE PRESENTATIONS: Case 1: A 49 year old female with multiple myeloma received an autologous hematopoietic stem cell transplant in October 2005. Eight days following her autograft she developed septic shock caused by Klebsiella oxytoca bacteremia which was successfully treated with intravenous meropenem and gentamicin. Case 2: A 29 year old female with sickle cell anemia and severe aplastic anemia underwent an allogeneic hematopoietic stem cell transplant in July 2005. Seven months following her unsuccessful allograft, she developed septic shock due to Klebsiella oxytoca bacteremia caused by a urinary tract infection. The septic episode was successfully managed with intravenous meropenem and gentamicin. Both patients were treated at King Faisal Specialist Hospital and Research Centre in Riyadh, Saudi Arabia. To our knowledge, they are the first reports of Klebsiella oxytoca bacteremias and septic shocks in hematopoietic stem cell transplant recipients. CONCLUSION: Klebsiella oxytoca should be considered as a possible cause of severe infections in recipients of various forms of hematopoietic stem cell transplantation. However, these infections may be complicated by bacteremias, septic shocks, systemic dysfunctions and even deaths if not managed promptly and appropriately.