Journal
TRANSPLANT INFECTIOUS DISEASE
Volume 12, Issue 6, Pages 555-560Publisher
WILEY-BLACKWELL
DOI: 10.1111/j.1399-3062.2010.00543.x
Keywords
multidrug resistant; Pseudomonas aeruginosa; liver transplant; biliary cast syndrome; combination regimen
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P>Both bacteremia and biliary cast syndrome are serious post-transplant complications in liver transplant recipients. In the setting of increasing drug resistance in the current era, management of infections caused by multidrug-resistant (MDR) bacteria has proven challenging. We present a case of a liver transplant recipient who developed biliary cast syndrome and intractable MDR Pseudomonas bacteremia that failed to resolve with conventional antimicrobial therapy and which was finally controlled by a novel combination regimen of colistimethate, doripenem, and tobramycin. Future studies validating the clinical efficacy of this combination strategy are warranted.
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