Grand Rounds

Persistent Pseudomonas Aeruginosa Infection in a child with Cystic Fibrosis – How to manage?


Lavina Desai*, Ira Shah**
* Seth G S Medical College, Mumbai, India, and **Pediatric Infectious Diseases, Levioza Health Care, Mumbai, India.

Address for Correspondence: Lavina Desai, Seth G S Medical College, India. Email: lavinadesai16@gmail.com


Clinical Problem:
A 6 month old girl was diagnosed to have cystic fibrosis (CF) in 2009 in view of recurrent respiratory tract infections and diarrhea with malnutrition. Sweat chloride conductivity test was positive (75 mmol/L equivalent NaCl). She tested positive for both the alleles of F508 mutation. She was started on pancreatin supplements and vitamins A, D, E and K following which her diarrhea subsided. She was hospitalized for the first time in December 2011. Her sputum cultures subsequently grew Bukholderia cepacia, Streptococcus pneumoniae, Klebsiella pneumoniae and Pseudomonas aeruginosa over the next few months. She was put on tobramycin nebulization along with N-acetyl cysteine nebulization. Her sputum cultures continued to grow Pseudomonas aeruginosa on and off. In December 2013, the P. aeruginosa was resistant to tobramycin and she was treated with oral ciprofloxacin and nebulized Colistin for 6 weeks. She was alright till February 2014 when she was hospitalized with pneumonia and was treated with Amikacin and Ceftazidime for 4 weeks. In view of poor weight gain, a percutaneous endoscopic gastrostomy (PEG) tube insertion was done in April 2014. She continued to have recurrent pneumonias due to P. aeruginosa for which she was on nebulized Colistin and finally succumbed to her disease in February 2018.

How to manage persistent pseudomonas aeruginosa infection in cystic fibrosis?


Previous Grand Rounds View All

I
Is it Gaucher’s Disease or Niemann-Pick’s disease?
Lavina Desai*, Ira Shah**
A three and a half-year-old girl, currently bedridden, presented in 2013 with progressive loss of milestones from two years of age. On examination she showed poor oral hygiene, oral thrush over the ha....
R
Right Lung Opacification – What is the diagnosis?
Ilechukwu GC, Kollannoor B, Abdulaziz M.
A previously well, 7 week old baby presented to the paediatrics accident and emergency unit with a history of cough and fast breathing of one week duration associated with reduced oral intake of <50%.....
S
Staphylococcus Aureus Infection and Internal Jugular Vein Thrombophlebitis
Shakil Shaikh, Vijay Raut, Ira Shah
Case Report: A 10 month old male child was referred in view of fever, anasarca and respiratory distress. He was treated with ceftriaxone by referring hospital for 3 days. On presentation to us, he had....
I
Infantile Hemangioendothelioma - How to treat?
Amit Dey*, Ira Shah**
A 1 months old boy presented with progressive abdominal distension since 1 month of age and breathlessness for a day. There was no jaundice or pallor. On examination, weight was 3.86 kg. His vital par....
J
Jaundice with triangular facies and pulmonary stenosis
Aditi Joshi*, Ira Shah**
A 2½ years old girl born of third degree consanguineous marriage presented with progressive abdominal distension for one and a half months along with jaundice at onset. There was no bleeding manifesta....
Disclaimer: The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.