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Hypothermia predisposing to Pseudomonas putida sepsis in a child with panhypopituitarism
Insights
Hypothermia may increase the risk of Pseudomonas putida infections. This case study suggests that lower body temperatures can promote bacterial growth, impacting patient recovery.
Area of Science:
- Infectious Diseases
- Endocrinology
- Microbiology
Background:
- A 14-year-old boy with a history of craniopharyngioma resection and panhypopituitarism presented with hypothermia and obtundation.
- The patient exhibited persistent low body temperature (<35°C) and signs of infection, including elevated C-reactive protein and leukocytosis with a left shift.
Observation:
- The patient developed a bloodstream infection with Pseudomonas putida, a bacterium known to have optimal growth at lower temperatures.
- Pseudomonas putida isolate demonstrated more rapid growth at 30°C compared to 37°C in laboratory experiments.
Findings:
- Treatment with antibiotics (amikacin and ceftazidime), fluid therapy, and hormone replacement normalized the patient's temperature and improved his condition.
- The patient's clinical course and laboratory findings suggest a link between hypothermia and susceptibility to Pseudomonas putida infection.
Implications:
- Hypothermia may be a predisposing factor for Pseudomonas putida infections in susceptible individuals.
- This case highlights the importance of considering temperature regulation in managing patients with endocrine disorders and infections.
Abstract:
A 14-year-old boy presented with a 1-week history of hypothermia and obtundation. His medical history included surgical resection of craniopharyngioma with postoperative visual impairment and panhypopituitarism. The patient's rectal temperature remained persistently lower than 35 degrees C during the first 3 days of hospitalization. His blood pressure was 90/56 mmHg on admission. The peripheral blood leukocyte count was 2.7 x 10(10)/L with 18% neutrophils, 19% band forms, 44% metamyelocytes, 3% myelocytes, and 16% lymphocytes. The C-reactive protein concentration was 133.9 mg/L. Two separate blood cultures both yielded Pseudomonas putida. The patient was treated with amikacin and ceftazidime along with aggressive fluid therapy. Replacement therapy directed at his hormonal deficiencies was initiated as soon as his hemodynamic status was stabilized. The patient responded well to therapy with a gradual rise in body temperature and improvement in general activity. A growth experiment carried out on the P. putida isolate showed that the bacteria grew more rapidly at 30 degrees C than at 37 degrees C. The clinical course of the patient, as well as the results of the laboratory study, suggest that hypothermia may predispose human infection with P. putida.