Persistent Bloodstream Infection with P. aeruginosa in a Patient with an Aortic Root Graft and a New Diagnosis of Lung Cancer

Abstract

Pseudomonas aeruginosa is the third most common gram-negative pathogen causing bloodstream infection (BSI) and is associated with an elevated mortality rate of up to 42%. The primary sources of infection are the pulmonary system, indwelling catheters, urinary tract, and soft tissue. BSI caused by vascular graft infection is 1-6% depending on the location of the graft. There is increasing prevalence of resistance of P. aeruginosa to antimicrobial agents, and oral agents are usually not considered as treatment of choice for P. aeruginosa BSI. Here, we report a case of persistent BSI with P. aeruginosa with the aortic graft as the primary source of infection. Patient did not go through aortic graft extraction due to new diagnosis of end stage lung cancer but was successfully managed by oral suppression therapy after failing a prolonged course of IV antibiotic therapy.