RESUMEN
We report the case of a cystic fibrosis patient colonized with a smooth-morphotype form of Mycobacterium abscessus who developed acute respiratory failure with the emergence of an isogenic rough (R) variant while he was recovering from peritonitis-induced shock. This report emphasizes the role of R forms in severe M. abscessus infections.
Asunto(s)
Fibrosis Quística/complicaciones , Infecciones por Mycobacterium/diagnóstico , Mycobacterium/aislamiento & purificación , Peritonitis/complicaciones , Insuficiencia Respiratoria/etiología , Adulto , Antibacterianos/uso terapéutico , Dermatoglifia del ADN , ADN Bacteriano/genética , Humanos , Masculino , Mycobacterium/clasificación , Mycobacterium/genética , Infecciones por Mycobacterium/tratamiento farmacológico , Infecciones por Mycobacterium/microbiología , Radiografía Torácica , Técnica del ADN Polimorfo Amplificado Aleatorio , Insuficiencia Respiratoria/terapiaRESUMEN
IMPLICATIONS: Patients with iatrogenic hypernatremia and serum sodium levels >170 mmol/L either die or sustain severe central nervous system damage. We report the first case of an adult patient who survived an extreme iatrogenic acute hypernatremia (200 mmol/L) resulting from a hypertonic saline irrigation of multiple intraabdominal hydatid cysts. It is a unique report of an intraoperatively developed serum sodium increase without subsequent neurological damage.