ISOLATION OF A RARE BACTERIUM, RAOULTELLA (KLEBSIELLA) ORNITHINOLYTICA, AFTER CHOLECYSTECTOMY: CASE REPORT

Year 2016, Volume: 11 Issue: 1, 0 - 0, 08.11.2016

Aykut Urfalıoğlu , Gökçe Gişi , Mahmut Arslan Arif Emre , Bora Bilal , Ömer Faruk Boran , Ayşe Balaban Hafize Öksüz

Abstract

 

ABSTRACT

Bacteria of the Klebsiella species are gram-negative aerobic bacilli which are members of the family Enterobacteriaceae.  K.ornithinolytica has been reported to cause the disease, Histamine Fish Fever characterized by excessive histamine release,  in humans after ingestion of raw fish. In this case we aimed to discuss a rare case who was reoperated with the suspicion of colon perforation after elective cholecystectomy and Gr(-) R.ornithinolytica was isolated from the intraabdominal fluid.

After elective cholecystectomy gaita and pus were observed on the abdominal drainage tubes of the 62 years old male patient. He had erythema and maculopapular rash on his face and upper extremities. His intraabdominal fluid cultured R.ornithinolytica. After treatment with imipenem the patient healed and he was discharged to the ward on the 3. postoperative day. 

In conclusion,  this bacterium should be kept  in mind in patients with histamine release symptoms such as maculopapular rash. Thus we can avoid delays in the treatment and use of inappropriate antibiotics.

Key words: Raoultella (Klebsiella) ornithinolytica, Histamine Fish Fever, elective cholecystectomy

KOLESİSTEKTOMİ SONRASI NADİR İZOLE EDİLEN BİR BAKTERİ RAOULTELLA (KLEBSİELLA) ORNİTHİNOLYTİCA: OLGU SUNUMU

Abstract

ÖZET

Klebsiella türü bakteriler, Enterobacteriaceae familyasına ait Gr(-), aerobik basillerdir. K. ornithinolytica’nın insanlarda çiğ balık tüketilmesiyle, yüksek oranda histamin salınımına neden olarak  ‘Histamin balık ateşi’ adı verilen zehirlenme tablosunu yaptığı bildirmiştir. Burada farklı olarak elektif kolesistektomi sonrası kolon perforasyonu düşünülerek yeniden operasyona alınan ve operasyon sırasında batın içi materyalden alınan kültürde Gr(-) R. ornithinolytica tespit edilen bu nadir olgunun sunulması amaçlanmıştır.

Elektif kolesistektomi operasyonu sonrası,  takiplerinde batın drenlerinden pü ve gaita gelen, yüzde ve üst ekstremitelerde eritem ve makülopapüler döküntüleri oluşan 62 yaşında erkek hastada, batın içi kültürde R. ornithinolytica tespit edilmiş, imipenem tedavisi sonrası düzelen hasta 3.gün yoğun bakımdan servisine gönderilmiştir.

Sonuç olarak, histamin deşarjı ile ilgili ani makülopapüler döküntü ve diğer histamin salınımı bulgularının görüldüğü hastalarda bu bakteri akla getirilmelidir. Böylece gerek tedavide zaman kaybının önlenmesi gerekse antibiyotik direnci ile ilişkili olarak gereksiz kullanımın sınırlandırılması mümkün olabilir.

Anahtar kelimeler: Raoultella(Klebsiella) ornithiniolytica, Histamin balık ateşi, elektif kolesistektomi

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