What Is The Cause And Treatment For Klebsiella In Stool

Posted on Wed, 5 Mar 2014

Question: Good afternoon Dear Doctor , My son is 10 month and a half old , and he was a colicky and gassy babe .About 2 weeks a go he start having high fever up to 39.8 and diarrhea and casual vomiting ,i did stool culture and analyses for him in which one we found klebsiella oxytoci , his ped gave us intermediar anitbiotic and now after 7 days of it he had again dhiareea for 2 days and his appetite is low and he is crunky .also i did stool culture again and there is an heavy growth of klebssiella in one lab and negative result in an other lab .i do not know what to believe but i think he is loosing wheight and he does not seem to be well even so his ped told me to do nothing than to waite .i need your advise . Thank you

Answered by Dr. Dr. Klerida Shehu (3 hours later)

Brief Answer: Following the answer to your queries... Detailed Answer: Hi XXXXXXX Thank you for sharing the concern of your baby with Healthcaremagic. I have read the results and you are right, the results after the treatment are worse than before the treatment with regards to the bacterial quantity. Please bare in mind that Klebsiella oxytoca is a normal habitant of the intestinal tract. It can rarely cause infection, especially in healthcare settings or community acquired or immuno-comprimised patients. This explains why the intensity of such bacteria in the first lab exams were reported as "heavy". Next, antibiotics (intermediate) you used are good option to eradicate this infection (if this problem is real of course). If the intensity of the pathogen was increased, then, the antibiotic was not the right choice or the germ has become resistant. If I was the caring doctor of your son, I'd ask to do: - abdominal ultrasound - repeat fecal examination for ova/parasites, but this time, you should send 3 samples in the lab for further evaluation. You can ask the lab to give you 3 containers with formalin 10% or other preservatives to test all the 3 samples. I'd also advise to get all the family members tested as well for ova/parasites. When collecting the stool, your son should defecate on a clean place (not directly to the WC) and mix well all the amount of feces, and pour it inside the container. - culture the stool for candida infection. Usually, intestinal candida infection is often associated with antibiotic use. Depending on the results, an immediate treatment with anti-mycotics should be started. - you should give probiotics and tasectan for the diarrhea to your son - give him plenty of water and otc o.r.s to prevent dehydration - apply good hygienic measures especially after changing his diapers or preparing his food - further evaluation of food intolerance is also recommended. Once again, discuss with his pediatrician about the real pathogenicity of klebsiella oxytoca. Hope it was of help! Feel free to ask me other questions you might have! I'd be happy to assist you further! Dr.Klerida

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Klerida Shehu (14 hours later)

Dear dr For how long shall i give him probiotic? now he is ok ...do you think that yougurt or XXXXXXX diary can have a conection with it ?

Answered by Dr. Dr. Klerida Shehu (5 hours later)

Brief Answer: Probiotics can be used up to 7 days... Detailed Answer: Hi back, Thank you for following up. The probiotic should be given up to 7 days. Yogurt is also a good source of lactobacilli and is advised to be used. With regards to dairies, if hygienic measures are applied (especially for the milk to be boiling enough to kill the bad bacteria); they can be used. Unless, if your child is having problem while eating dairies,, should run intolerance tests for further evaluation. Once again, Klebsiella oxytoca is normally found in our skin and gut. If hygiene is poor, it can cause infection, especially when immune system is weak (or immature as in case of your baby). Hope it was of help! Dr.Klerida

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Klerida Shehu (46 hours later)

Dear Dr.Klerida , i have done one other culture for my son and the result is shoeing that he is having positive Campylobacter .Really i understand nothing as i have dobe the stool test in 3 labs and all with 3 different answers . It is really annoying me . It is that possibile? PLease advise

Answered by Dr. Dr. Klerida Shehu (15 hours later)

Brief Answer: Following suggestions... Detailed Answer: Hi, Thank you for following up. It is great to deal with a caring mother as you. Finally, the real culprit was found (Campylobacter). Yes, it is possible. It is a common pathogen caused if the hygienic measures are not taken properly. If you are not the only one taking care of your baby; I'd suggest to train the other person who is taking care of him about proper hygienic measures, especially when changing diapers or preparing the food. As he is taking long courses of antibiotics, I strongly suggest to give give anti-mycotic drug (you did not mention if you did the culture for candida) together with lots of fluids and probiotics. I also insist to send 3 samples of stool for ova/parasites to rule out intestinal parasites. All the best! Dr.Klerida

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Above answer was peer-reviewed by : Dr. Raju A.T