Case 38

Patient #38 was 89 years (Covid19 negative) with a past medical history of dementia, cerebral vascular disease and Parkinson’s disease who presented to the emergency department with respiratory distress and hypoxemia. Chest x-ray on 11Oct2020 was unchanged from previous x-rays. Sputum cultures on 21Oct2020 and 26Oct2020 were positive for CRAB and phage therapy was initiated on 28Oct2020 twice a day for 16 days. Eight sputum cultures from 28Oct2020 to 10Nov2020 remained positive. Four blood cultured taken from 21Oct2020 to 09Nov2020 were negative. One of 5 urine cultures was positive for CRAB on 21Oct2020. No adverse events were reported as related to phage therapy. The AST/ALT/ALP/TB liver enzymes were relatively normal (elevated ALP) on 24Oct2020, four days prior to phage therapy. These levels increased significantly over normal ranges on 11Nov2020 when the patient expired.