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Ghorashi et al. Journal of Medical Case Reports 2011, 5:241 http://www.jmedicalcasereports.com/content/5/1/241

JOURNAL OF MEDICAL

CASE REPORTS
Open Access

CASE REPORT

Arthritis, osteomyelitis, septicemia and meningitis caused by Klebsiella in a low-birth-weight newborn: a case report
Ziaaedin Ghorashi1, Nariman Nezami2*, Hamideh Hoseinpour-feizi1, Sona Ghorashi3 and Jafar Sadegh Tabrizi4
Abstract
Introduction: Klebsiella pneumoniae is in most cases a hospital-acquired infection and presents as pneumonia, septicemia and meningitis in patients with some predisposing factors, including prematurity, intravenous catheter, history of antibiotic therapy and intravenous nutrients. Case presentation: A low-birth-weight, 33-day-old Caucasian girl with respiratory distress syndrome was admitted to our hospital. She developed septicemia, meningitis, polyarticular arthritis and osteomyelitis by nosocomial K. pneumoniae which was resistant to most antibiotics except ciprofloxacin. She was therefore treated with ciprofloxacin and co-trimoxazole for eight weeks. After completion of the treatment course, she completely improved with excellent weight gain and without any adverse effects during three years of follow-up. Conclusion: In the resistant strain of K. pneumoniae, ciprofloxacin could be considered as a therapeutic option with the prospect of a good outcome, even in neonates and infants.

Introduction Pneumonia is a type of infection that is most commonly caused outside the hospital by Klebsiella pneumoniae [1]. Mostly, K. pneumoniae is recognized as a hospitalacquired infection presenting as pneumonia, septicemia and meningitis in patients with some predisposing factors (including prematurity, intravenous catheter, history of antibiotic therapy and intravenous nutrients) [2,3]. In the rare patients with underlying conditions among newborns and older adults, K. pneumoniae may result in arthritis and osteomyelitis. All Klebsiella subtypes are resistant to ampicillin,