Patient Case: 62-year-old leukemia patient

Institution Withheld

Hospital in the U.S.

Febrile Neutropenia Patient

62 yo male with AML presented to ED. Patient recently completed 3rd chemotherapy round and was neutropenic

Empiric therapy Piperacillin-tazobactam
ID/AST method Accelerate PhenoTest® BC kit
ID result Citrobacter spp.
Therapy change Meropenem
AST results Piperacillin-tazobactam (R), ceftazidime (R), ceftriaxone (R), aztreonam (R), ciprofloxacin (R)
Therapy continuation Meropenem
Time to AST results ∼7h post +BC with Accelerate PhenoTest® BC kit
Patient outcome Discharged home

Case Discussion

A 62-year-old man with acute myeloid leukemia (AML) presented to the emergency department with fever. The patient had just completed his third chemotherapy cycle and was neutropenic on presentation. Blood cultures were collected at 15:57. The patient was started on empirical piperacillin-tazobactam (TZP) and admitted to the hospital. Citrobacter spp. was reported and a change was made to meropenem. The Accelerate Pheno system susceptibility results confirmed the continuation of meropenem.

The patient defervesced on the third hospital day, and follow-up blood cultures were negative. The following day, his PICC line was removed due to presence of thrombus. The patient was switched to ertapenem therapy for two weeks. After completion of this therapy, the patient was discharged home in good health.

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