Yaita Kenichiro, Sameshima Ichiro, Takeyama Hideaki, Matsuyama Shinpei, Nagahara Chie, Hashiguchi Ryo, Moronaga Yukiko, Tottori Nami, Komatsu Masanari, Oshiro Yusuke, Yamaguchi Yukihiro
Division of Infectious Diseases, Kenwakai Otemachi Hospital, Japan.
Intern Med. 2013;52(12):1407-12. doi: 10.2169/internalmedicine.52.9296.
A 77-year-old man had undergone left-lobe liver resection and a choledochojejunostomy six years previously, and thereafter he suffered from a postoperative relapse of cholangitis. He was admitted to our hospital due to liver abscesses and bacteremia caused by multidrug-resistant Pseudomonas aeruginosa. Empirical treatment with piperacillin/tazobactam was started, and the patient initially recovered. However, he developed a second case of sepsis caused by piperacillin/tazobactam-resistant P. aeruginosa bacteremia originating from a new liver abscess. We changed the piperacillin/tazobactam to colistin and flomoxef and continued the two antibiotics for one month. During the antibiotic therapy, the patient successfully underwent bile duct stent placement.
