Calciphylaxis complicated by NDM-1-producing Pseudomonas aeruginosa: first experience with cefepime-zidebactam alongside phage therapy in the USA.
Erlinda R Ulloa, Daniel Jaffurs, M Tuan Tran et al.
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Case in brief
A young woman with acute myeloid leukaemia presented with calciphylaxis, characterized by arteriolar calcification and ischemic skin necrosis. Her condition was complicated by superinfection with a pan-resistant New Delhi metallo-β-lactamase-1-producing Pseudomonas aeruginosa. Management included the novel use of cefepime-zidebactam and bacteriophage therapy, leading to a favorable outcome despite the complexity of her diagnosis.
What made this case unusual
The case involved one of the earliest domestically acquired isolates of a pan-resistant Pseudomonas aeruginosa, which is typically associated with international travel.
Diagnostic / clinical pearl
Clinicians should consider calciphylaxis in patients with acute myeloid leukaemia presenting with ischemic skin lesions, especially when complicated by unusual infections.
Why it matters
This case underscores the importance of innovative therapeutic strategies in managing complex infections associated with rare conditions like calciphylaxis.