Multi-Sites Infection Caused by Klebsiella pneumoniae After Hemopoietic Stem Cell Transplantation

Abstract

Introduction: Leukemia patients can easily become hypoimmunity after hemopoietic stem cell transplantation, endogenous infection often happens in these patients. Meanwhile, Klebsiella pneumoniae is often isolated from various specimens in inpatient. It can lead to infections in the whole body, especially in those immunosuppressed patients. Case Presentation: A 22-year-old girl with complete remission after chemotherapy for her acute lymphoblastic leukemia was presented to the 2nd affiliated hospital of Zhejiang University for hemopoietic stem cell transplantation. She got a good check-up, however, her spirit was a little bad. Her primitive lymphocyte (0.06%) and total lymphocyte (27.05%) in the peripheral blood were in the normal range. She received a 224 mL stem cell transfusion including mononuclear cell (4.87 × 10 8 /kg) CD34+ (0.6%) as well as reached the transplantation threshold of CD34+ cell (3 × 10 6 /kg). Nine days after transplantation, there were no severe side effects except a little bit of vomit. However, the symptom of diarrhea appeared first. K. pneumoniae was isolated from the stool, then invaded into the blood, and caused sepsis. It disseminated and caused multi-sites infection. Conclusions: It should be kept in mind that K. pneumoniae can translocate across the intestinal epithelium. It is important to pay attention to the bacterium isolated from the intestine in immunosuppressed patients.