KLEBSIELLA-AEROBACTER PNEUMONIA IN INFANTS

A Review of the Literature and Report of a Case

¹ Pediatric Department, Boston City Hospital

Klebsiella pneumoniae and Aerobacter aerogenes organisms are indistinguishable by standard laboratory methods and should be grouped under the single name Klebsiella-Aerobacter in clinical discussions. Though serotypes 1, 2, and 4 are usually implicated in severe respiratory disease in adults, any type may prove pathogenic in infants. A case of Klebsiella-Aerobacter pneumonia in a 7-week-old infant in which a Type 16 organism was lethal is presented. The disease took a fulminating course, characterized by copious secretion of thick purulent mucus, in which a great number of Klebsiella-Aerobacter were found. These diminished rapidly following antibiotic therapy, but the patient died from the flooding of her respiratory passages with secretions.

The 36 cases of this condition reported in the world literature are discussed, with particular emphasis on early diagnosis and effects of antibiotic therapy. The mortality in sporadic cases is four times that reported during epidemics. The diagnosis is seen to be particularly elusive and is complicated by the use of drugs prior to culture. The significance of throat carriers, especially during periods of increased incidence is difficult to interpret. Gram stains of tracheal secretions are singled out as a simple procedure helpful in making a quick diagnosis and in following the effect of antibiotic therapy. A combination of streptomycin and chloramphenicol is suggested as the antimicrobial combination of choice, effective in over 90% of in vitro studies.

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