A case report of the eradication of pseudomonas aeruginosa from leg ulcer in a patient with essential thrombocythemia.
A patient treated with hydroxyurea had a lower extremity ulcer that was found infected with Pseudomonas aeruginosa. Drug discontinuation and ceftazidime treatment did not initially lead to resolution due to misidentification of inducible betalactamases expressed by the organism and subsequent clinical failure of the cephalosporin in eradicating infection. These class C enzymes may be strongly induced after betalactam exposure and confer resistance to penicillins, cephalosporins, betalactamase inhibitors but not to carbapenems. Though hydroxyurea represents a major cause of essential thrombocythemia-related ulcers, lesion infections by difficult-to-treat organisms should be eradicated to promote wound healing.
Savini
Vincenzo
V
Clinical Microbiology and Virology Unit, Department of Transfusion Medicine, Spirito Santo Hospital, Pescara (Pe), Italy. vincsavi@yahoo.it
Catavitello
Chiara
C
Bianco
Azaira
A
Balbinot
Andrea
A
D'Antonio
Domenico
D
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002442:Ceftazidime / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D016523:Foot Ulcer / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000150:complications / Q000188:drug therapy*; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification*; D013921:Thrombocytopenia / Q000150:complications* / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D002442:Ceftazidime