10 December 2021: Articles
as a Cause of Pneumonia and Disseminated Infection in Febrile Neutropenia: A Case Report and Literature Review
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Rare disease
Batool M. Abu Ali C* , Hibah Alzayer D , Marwan Jabr Alwazzeh D , Asim Diab DDOI: 10.12659/AJCR.933694
Am J Case Rep 2021; 22:e933694
Table 1. Important laboratory findings and antimicrobial management during ICU admission.
| Date | CRP (mg/dL) (0.1–5) | WBC (k/µl) (4.0–11) | ANC* (cell/µl) (1.5–8) | Procalcitonin (ng/mL) <0.1 | Culture site and findings | Antimicrobial treatment |
|---|---|---|---|---|---|---|
| 9 April | 40.56 | 0.2 | 0 | 137.40 | Pseudomonas aeruginosa (blood) | Vancomycin 1 g i.v. every 12 h,Meropenem 1 g i.v. every 8 h |
| 12 April | 22.13 | 0.1 | 0 | 27.37 | No growth (blood) | Fluconazole started (800 mg i.v. loading dose then 400 mg IV every 24 h) |
| 15 April | 28.01 | 0.3 | 0 | 3.90 | No growth (blood) | No change |
| 18 April | 26.20 | 0.2 | 0 | 3.40 | No growth (blood) | No change |
| 21 April | 20.14 | 0.4 | 0 | 3.33 | No growth (blood) | No change |
| 24 April | 28.12 | 0.2 | 0 | 3.47 | No growth (blood) | No change |
| 27 April | 32.97 | 0.8 | 1 | 4.70 | No growth (blood) | Antifungal treatment shifted to Caspofungin (70 mg i.v. loading dose then 50 mg i.v. every 24 h) |
| 30 April | 35.68 | 1.1 | 1 | 6.31 | (blood, TA) | No change |
| 2 May | 39.7 | 1.3 | 1 | 6.54 | (TA) | Caspofungin stopped, Amphotericin B lipid complex 300 mg i.v. every 24 h started |
| TA – transtracheal aspirate. * ANC=WBC×(PMN^/100)+(Bands/100)^polymorphonuclear neutrophil. | ||||||