The patient was admitted to the hospital with COPD exacerbation and respiratory distress.
Discussion
This case highlights how the T2Bacteria Panel can guide treatment by rapidly identifying the causative pathogen in sepsis cases that are missed by blood cultures. Rapid detection of bloodstream infection by T2Bacteria could have allowed for the escalation of effective antibiotic therapy, potentially leading to the prevention of further clinical deterioration.
Presentation
The patient was admitted to the hospital with COPD exacerbation and respiratory distress. They were subsequently transferred to the ICU with respiratory failure requiring intubation and renal failure. Antibiotics were initiated at the time of admission, but no cultures were obtained. The patient continued to have fever and leukocytosis and on day 5 of hospitalization, blood cultures and T2Bacteria Panel were obtained.
Patient Selection Criteria
Patients with sepsis presenting to ICU from the Emergency Department
Evaluation and Treatment Decision
Diagnosis
fever of unknown origin, possible bloodstream infection
T2Bacteria Result
Positive for P. aeruginosa
Blood culture Result
no growth
Empiric Therapy
Ceftriaxone
Decision making based on T2Bacteria Result
T2Bacteria and blood cultures were obtained after 5 days of antibiotic therapy for an infectious workup for persistent leukocytosis and fever of unknown origin. Because this case was part of an observational study, T2Bacteria results were not reported. Had T2Bacteria been performed and results reported immediately after collection, it may have prompted the physician to add targeted therapy and avoid clinical deterioration.
