Kluyvera cryocrescens finger infection: Case report and review of eighteenKluyvera infections in human beings

We report a case of soft tissue infection with Kluyvera cryo-crescens and a critical review of Kluyvera infections. A 31-year-old diabetic man used a new chemical for stripping the floor with his bare hands. Two days Inter he developed a blister all a finger which progressed to tenosynovitis in spit e of intravenous nafcillin therapy. After II days culture and sensitivity r esults dictated treatment with intravenous ticarcillin/clavulanic acid. The wound was debrided twice, and lai er a skin flap was done. Wound cultures became sterile after 7 days of treatment with ticarcillin/clavulanic acid, and he recovered. This case represents the fourth clinical infection with K . cryo-crescens and the eighteenth of Kluyvera to be reported. Four others were K. ascorbata, and the remaining ten Kluyvera infections iir humans mer e not identified beyond genus. Our case and review of the 17 previous cases emphasize that while Kluyvera rarely cause disease, these opportunistic Gr amnegative bacilli may be virulent in a variety of sites tinder as yet pear ly defined host conditions. Sites of infection varied, but the brain and me ninges were not among them. Two patients had diabetes mellitus, more had AI DS, and Jour died. Oner shown clinically to be the cause of an infection, K luyvera deserve aggressive treatment which acknowledges their ampicillin re sistance. (C) 1998 Elsevier Science Inc.