A Rare Case of Burn Sepsis Caused by Burkholderia Cepacia
Objective — acquaintance with the case of successful treatment of a patient with severe burn disease, complicated with burn sepsis caused by Burkholderia cepacia. Material and methods. Patient L., born in 1974, underwent treatment in burn department of state institution «institute of urgent and reconstructive surgery named after V.K. Gusak of National academy of medical sciences of Ukraine» from 20.07.12 till 22.10.12 for flame burn and burn by hot metal of I–IV degree on face, neck, body, arms and legs of 50 (40) % of the body surface, mild thermal inhalation injury, severe burn disease, complicated with burn sepsis, septic bilateral pneumonia, toxic encephalopathy, anemia, right-sided gonitis, spontaneous secondary necrosis of left shoulder soft tissues. Multiple bacterial inoculation from venous blood (central vien) and from burn wound had been carried out on an automatic analyzer Vitek (France). Results. We performed blood cultures and isolated B.cepacia at a titer of 107 CFU/ml. A massive therapy, according to the sensitivity, has been carried out using three antibiotics — meropenem, ceftazidime, levofloxacin). There were multiple transfusions of packed red blood cells, fresh frozen plasma, albumin, ozonated normal saline, hydroxyethyl starch, crystalloids, amino acids. The patient received glucocorticoids, vitamins, disaggregants, decongestants and diuretics, proton pump inhibitors, analgesics, immune drugs, hematopoiesis stimulants, antifungals, enteral and parenteral nutrition against the surgical treatment. Membrane plasmapheresis was performed two times. As a result of the treatment the general condition of the patients improved, he mobilized and began to walk with elastic bandages. Areas with osteonecrosis gradually closed. The patient was discharged in satisfactory condition. Conclusions. Timely and repeated bacteriological examination and pathogenetic treatment based on the sensitivity of bacteria to antibiotics, which also includes extracorporeal detoxification methods, passive and active immunotherapy, allowed for the successful eradication of the pathogen and prevent death in severe burn sepsis.