Case 36

Patient #36 was 66 years old with a past medical history significant for major depression, anxiety, asthma, diabetes mellitus, elevated cholesterol. The patient presented with worsening shortness of breath, fever, chills and generalized weakness. Covid-19 positivity was noted since 01Sept2020. The patient had acute hypoxemia and respiratory failure secondary to Covid19 was placed on bilevel positive airway pressure. Chest x-ray on 07Sept2020 showed bilateral infiltrates. The sputum culture was positive for CRAB on 09Oct2020 resistant to all antibiotics but had intermediate susceptibility to tigecycline. Phage therapy was initiated on 14Oct20020 over 2 weeks. Twelve sputum cultures were taken between 08Sep2020 and 3Nov2020 and thirteen blood cultures were taken between 07Sep2020 and 27Oct2020. The sputum cultures were 2+ positive prior to therapy and 1+ positive for CRAB. All blood cultures were negative for CRAB. No adverse events were reported as related to phage therapy. Liver enzymes AST/ALT/ALP were within normal limits on 14Oct2020 prior to the start of phage therapy and gradually increased until 08Nov2020, the day the patient expired.