title: Successful treatment of cepacia syndrome with a combination of intravenous cyclosporin, antibiotics and oral corticosteroids.
abstract: Burkholderia cepacia complex (BCC) is a group of 17 closely related bacterial species that can cause pulmonary infection in patients with cystic fibrosis (CF). The clinical manifestations of BCC infection are varied but can include cepacia syndrome, which is a rapidly progressing necrotising pneumonia with an almost universally fatal outcome. We report the case of a 38 year old man, known to have chronic infection with the ET12 strain of Burkholderia cenocepacia who developed cepacia syndrome 26 years after initial infection. Aggressive treatment with a combination of 4 intravenous antibiotics, oral corticosteroids and cyclosporin brought about clinical, radiological and biochemical resolution of his cepacia syndrome. This case highlights the possible role of cyclosporin in the treatment of cepacia syndrome.
authors.affiliation: Manchester Adult Cystic Fibrosis Centre, University Hospital of South Manchester, Southmoor Road, Manchester, M23 9LT, UK. fjgilchrist@hotmail.com
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Gilchrist
authors.forename: A Kevin
authors.initials: AK
authors.lastname: Webb
authors.forename: Rowland J
authors.initials: RJ
authors.lastname: Bright-Thomas
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Jones
mesh_terms: D061605:Administration, Intravenous; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019121:Burkholderia Infections / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D042602:Burkholderia cepacia complex / Q000187:drug effects / Q000302:isolation & purification; D016572:Cyclosporine / Q000008:administration & dosage*; D003550:Cystic Fibrosis / Q000150:complications*; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008168:Lung / Q000473:pathology*; D008297:Male; D009336:Necrosis; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D013183:Sputum / Q000382:microbiology; D013577:Syndrome; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine