A 58-year-old female with a history of metastatic breast cancer presented to the clinic.
Discussion
This case highlights the ability of the T2Bacteria® Panel to provide rapid species identification and detection of the causative organisms when blood cultures do not, including polymicrobial infections.
This high-risk, immunocompromised patient was initially treated with ceftriaxone and azithromycin for empiric treatment of pneumonia. Rapid species identification prompted an escalation of therapy to the anti-pseudomonal antibiotic, cefepime. The patient defervesced the day after therapy escalation and continued to clinically improve with cefepime continuation until hospital discharge. Without the availability of T2Bacteria, the patient may have remained on inappropriate therapy for days until further clinical deterioration may have led to an empiric switch/broadening of therapy
Presentation
A 58-year-old female with a history of metastatic breast cancer presented to the clinic with shortness of breath, fever, and pancytopenia. She was then admitted to the hospital with orders for blood cultures, T2Bacteria, and empiric antibiotics.
Patient Selection Criteria
The patient was admitted to the hematology-oncology unit with a suspected bloodstream infection
Evaluation and Treatment Decision
Diagnosis
Pneumonia
Empiric Therapy
Ceftriaxone and azithromycin
T2Bacteria Result
Positive for P. aeruginosa and E. coli
Blood Culture Result
No growth
Chest x-ray
Evidence of right lower lobe pneumonia
Decision making based on T2Bacteria Result
A rapid T2Bacteria result allowed for the identification of the P. aeruginosa and E. coli bacteremia in a patient with a culture-negative infection. This prompted the prescriber to escalate therapy to cefepime for the coverage of the P. aeruginosa that was not identified via the blood culture.