A 52/F professional from high socioeconomic status reported with low-grade irregular fever for 20 days and night-sweat only. No cough/sputum, no enlarged LNs, no coexisting disease. CXR> a consolidation with a satellite one in Rt upper lobe. CECT> a lesion with a small cavity on the base of anterior segment (RUL). Slight neutrophilic leukocytosis. Procal> normal. BAL culture> Delftia acidovorans + Streptococcus. All other reports are within normal limits. Leads a healthy family life, has no H/O I/V drug use (IDU). What should be the line of treatment, please?
# You may please redirect this to any renowned microbiologist/ID specialist you know.
In a case report:
Can J Infect Dis Med Microbiol. 2015 Sep-Oct; 26(5): 277–279. Delftia acidovorans: A rare pathogen in immunocompetent and immunocompromised patients
Huseyin Bilgin et al.
the authors state:
"The organism was susceptible to expanded- and broad-spectrum cephalosporins, carbapenems and piperacillin-tazobactam, but resistant to ampicillin-sulbactam, gentamycin, amikacin, ciprofloxacin and colistin."
Dear Prof. Christian G Meyer , Thank you for the valuable link. Although its not common in immunocompetent patients, but its appears as a dangerous one sometimes, indeed; Resistant to many antimicrobials! It forms cavity also!! There are instances of relapses even!!! I understand - obtaining an early and correct culture & sensitivity is crucial here. Thanks once again. Regards- Rabiul.
Being Delftia a. a Gram negative bacterium , it should be sensitive to carbapenem antibiotics. What is about a culture with antibiotic challenge in vitro? Was it a multiresistent variant?
Dear Gianfranco Calogiuri , no, it wasn't multiresistant. The CS was as following:
What's about Ceftriaxone 1gr. Bis in die? One shot, two birds..
Yes, Ceftriaxone is a good choice, but it is vastly used in our community for a long time, its efficacy is questionable now! And that literature recommended to go for 4th generation Cephalosporins. So, the patient is getting Inj. Cefepime 1 gm I/V 8 hourly now and improving clinically, but image change is slow! Regards.
Recommended treatment for community acquired pneumonia is ceftriaxone as Dr. Rabiul Alam suggests.
Article Delftia Acidovorans : A Rare Pathogen in Immunocompetent and...
- Badges
- Science topic
- Similar topics
- Mathematics
- Statistics
- Sampling Design
- Sample Size