Complex Management of Respiratory Failure, Atrial Fibrillation, Ventricular Tachycardia, and Stenotrophomonas maltophilia in a Patient Following Osteomyelitis Amputation: A Case of Multisystem Complications Occurring Postoperatively.
| Autor: | O'Rorke J; Medicine, Lee Health, Fort Myers, USA.; Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA., Butler WG; Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA., Mason K; Internal Medicine, Cape Coral Hospital, Fort Myers, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2024 Nov 12; Vol. 16 (11), pp. e73505. Date of Electronic Publication: 2024 Nov 12 (Print Publication: 2024). |
| DOI: | 10.7759/cureus.73505 |
| Abstrakt: | Stenotrophomonas maltophilia is an opportunistic, multidrug-resistant gram-negative bacterium often affecting patients with significant comorbidities. This case report examines the hospital course of a 75-year-old male with a history of atrial fibrillation and heart failure with preserved ejection fraction (HFpEF), who presented with compromised respiratory status and recurrent infections, highlighting the complexities of clinical management in the setting of multidrug-resistant HFpEF organisms and postoperative complications. The patient was admitted following an episode of ventricular tachycardia and acute respiratory failure, requiring rapid airway management and intensive clinical intervention. His recent hospitalization for sepsis, pneumonia, and osteomyelitis complicated his clinical profile, particularly given his recurrent urinary tract infections (UTIs), which prevented the use of sodium-glucose cotransporter-2 inhibitor therapy for heart failure management. Respiratory cultures confirmed the presence of S. maltophilia , prompting treatment with minocycline and piperacillin-tazobactam. This case highlights the significant risks associated with postoperative arrhythmias in patients with underlying cardiac disease, particularly when superimposed with sepsis. Furthermore, the management of recurrent UTIs posed a barrier to optimizing heart failure therapy, further complicating the patient's clinical stability. The need for vigilant monitoring and tailored therapeutic strategies is essential to improve outcomes in this vulnerable patient population. The interplay between multidrug-resistant infections, arrhythmias, and comorbidities emphasizes the importance of comprehensive clinical management and the need for further research to develop targeted therapies and clinical plans for at-risk populations. Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, O'Rorke et al.) |
| Databáze: | MEDLINE |
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