Case 32

Patient #32 was 54 years old with a past medical history of hypertension, elevated hyperlipidemia, muscular dystrophy, status post inferior vena cava filter placement, sick sinus syndrome and status post pacemaker, chronic obstructive pulmonary disease on home oxygen therapy, type 2 diabetes mellitus, hypothyroidism and was diagnosed with Covid19 on 13Sep2020. Upon presentation to the emergency department the patient was in acute respiratory failure with a chest x-ray showing complete opacification of the right lung and multiple patchy opacities of the left lung. The patient was ventilated on 20Sept2020. Phage therapy was started on 07Oct2020 and was administered twice a day for 28 days. During hospitalization, six blood cultures from 20Sep2020 to 31Oct2020 were negative. Thirteen sputum cultures were taken from 21Sep2020 to 5Nov2020 12 of which were positive for CRAB which were intermediate resistant to amikacin, gentamycin, and tobramycin. Sputum cultures on 02Nov2020 and 05Nov2020 were both 3+ positive upon semiquantitative culture. No adverse events were reported as related to phage therapy. Liver enzymes AST/ALT/ALP were elevated beyond normal ranges on 15Oct2020 but decreased to expected levels at the time phage was discontinued. The patient expired on 06Nov2020.