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- Title
Rhodotorula mucilaginosa Fungemia in an Infected Biloma Patient Following a Traumatic Liver Injury.
- Authors
Mokhtar, Mohammad Nizam; Rahman, Raha Abdul; Abdullah, Farah Hanim; Azaharuddin, Izzuddin; Izaham, Azarinah; Ding, Chuan Hun
- Abstract
Rhodotorula mucilaginosa fungemia is rare and highly resistant to antifungal therapy. We herein report a case involving a 31-year-old male admitted after a high-velocity road traffic accident. He sustained a grade IV liver injury with right hepatic vein thrombosis, which necessitated an urgent laparotomy. Post-operatively, repeated imaging of the abdomen revealed the presence of a biloma. Percutaneous subdiaphragmatic drainage was carried out but appeared ineffective, prompting a second surgery for an urgent hemi-hepatectomy. The patient was then nursed in the intensive care unit (ICU); however, during his stay in the ICU, he became more sepsis, which was evident by worsening ventilatory support and a rise in septic parameters from the biochemistry parameters. Despite intravenous piperacillin–tazobactam and fluconazole, his septic parameters did not improve and a full septic workup was conducted and was found to be positive for Rhodotorula mucilaginosa from the blood cultures. After discussion with the infectious disease physicians and clinical microbiologists, it was decided to initiate a course of intravenous meropenem and amphotericin B based on minimum inhibitory concentration (MIC) values, considering the patient's extended ICU stay and catheter use. Eventually, after successfully weaning off mechanical ventilation, the patient was discharged from ICU care. This case underscores the necessity of individualized approaches, combining timely imaging, appropriate drainage techniques, and tailored treatments to optimize outcomes for such intricate post-traumatic complications.
- Subjects
THROMBOSIS surgery; TRAFFIC accidents; DIGESTIVE system diseases; BILE; ABDOMINAL surgery; HOST-bacteria relationships; TREATMENT effectiveness; DISCHARGE planning; LIVER diseases; INTRAVENOUS therapy; FUNGEMIA; MEDICAL drainage; INTENSIVE care units; AMPHOTERICIN B; ARTIFICIAL respiration; POSTOPERATIVE period; HEPATECTOMY; LENGTH of stay in hospitals; VENTILATOR weaning; INDIVIDUALIZED medicine; YEAST; LIVER blood-vessels; HEMORRHAGE; ABDOMINAL radiography; BIOMARKERS; MEROPENEM; DISEASE complications
- Publication
Healthcare (2227-9032), 2024, Vol 12, Issue 9, p880
- ISSN
2227-9032
- Publication type
Article
- DOI
10.3390/healthcare12090880