ABSTRACT
We report the case of a cystic fibrosis patient colonized with a smooth-morphotype form of Mycobacterium abscessus who developed acute respiratory failure with the emergence of an isogenic rough (R) variant while he was recovering from peritonitis-induced shock. This report emphasizes the role of R forms in severe M. abscessus infections.
Subject(s)
Cystic Fibrosis/complications , Mycobacterium Infections/diagnosis , Mycobacterium/isolation & purification , Peritonitis/complications , Respiratory Insufficiency/etiology , Adult , Anti-Bacterial Agents/therapeutic use , DNA Fingerprinting , DNA, Bacterial/genetics , Humans , Male , Mycobacterium/classification , Mycobacterium/genetics , Mycobacterium Infections/drug therapy , Mycobacterium Infections/microbiology , Radiography, Thoracic , Random Amplified Polymorphic DNA Technique , Respiratory Insufficiency/therapyABSTRACT
IMPLICATIONS: Patients with iatrogenic hypernatremia and serum sodium levels >170 mmol/L either die or sustain severe central nervous system damage. We report the first case of an adult patient who survived an extreme iatrogenic acute hypernatremia (200 mmol/L) resulting from a hypertonic saline irrigation of multiple intraabdominal hydatid cysts. It is a unique report of an intraoperatively developed serum sodium increase without subsequent neurological damage.
