Management of Cepacia syndrome in an immunocompetent non-cystic fibrosis adult patient.

Burkholderia cepacia complex (BCC) is nonfermenting, Gram-negative bacteria known to cause high morbidity and mortality. They commonly affect patients with cystic fibrosis (CF) and are often missed in those without, despite being fatal if left untreated. We report a case of cepacia syndrome in a 42-year-old, immunocompetent man without CF who initially presented with sepsis secondary to pneumonia. Multiple isolates from blood, synovial fluid, and wound swabs grew BCC. Treatment options and management strategies remain poorly understood for BCC in general and in cases without CF in specific. We successfully treated the patient using a combination of intravenous and inhalational antibiotics. This case report elaborates on the disease presentation, investigations, and management strategy employed to treat this rare infection.

Typical asthmatic presentation of congenital vascular ring can masquerade a general physician.

A 24-year-old woman was referred to pulmonologist with worsening breathlessness and wheeze. During childhood, she was diagnosed with asthma and subsequent exacerbations were treated with bronchodilators for many years. The chest X-ray and a spirometry testing raised a doubt of extrinsic tracheal compression and a subsequent enhanced chest CT (computerized tomogram) scan confirmed a right-sided aortic arch and a vascular ring anomaly compressing the trachea. Standard surgical division of ligamentum arteriosum was able to relieve the trachea and so the symptoms.