Second-trimester miscarriage caused by recurrent Klebsiella pneumoniae infection: a case report

Klebsiella pneumoniae (K. pneumoniae) can cause hospital- and community-acquired pneumonia, and urinary tract, wound, and blood infections. As there are few reports on K. pneumoniae infections in pregnancy and no treatment guidelines, diagnosis and treatment are difficult. The diagnosis and treatment require a bacterial culture to confirm the diagnosis. Therefore, the condition is often exacerbated due to a lack of timely medication.

We report a case of a pregnant woman with recurrent K. pneumoniae infection during pregnancy. The 40-year-old woman was admitted to hospital at 14 weeks gestation due to fever of unknown origin. She was treated with empiric antibiotics, and her fever resolved within 1 day. A blood culture showed K. pneumoniae infection. She was discharged after 11 days of treatment. However, 10 days later, she was re-hospitalized due to fever, and treated with cefoperazone sodium and sulbactam sodium. Her fever resolved within 1 day. A blood culture again showed K. pneumoniae infection. On day 5, she experienced chills and a miscarriage. Cervical secretions showed K. pneumoniae, and a placental examination revealed chorioamnionitis. The treatment was changed to meropenem, and the patient recovered within 2 weeks.

When a fever of unknown origin occurs during pregnancy, one should be wary of K. pneumoniae recurrence or secondary infection, and use sensitive antibiotics early. When K. pneumoniae is cultivated, the course of treatment must be sufficient, and the source of infection must be actively searched to prevent secondary infections, such as kidney cysts, liver cysts, lung cysts, and community infections. Finding the cause and taking appropriate treatment can prevent the occurrence of adverse pregnancy and childbirth history.