A 40 years old patient came with complaints of spikes of fever and difficulty in breathing. Transesophageal ECHO found out the vegetations in the hea. The culture was positive for Burkholderia cepacia. Drug of choice for Burkholderia cepacia pneumonia is:
Aminoglycoside and colistin
Carbapenems with 3rd generation cephalosporins
Tigecycline and cefipime
Cotrimoxazole with 3rd generation cephalosporins
Answer- D. Cotrimoxazole with 3rd generation cephalosporinsDrug of choice for B. cepacia is TMP-SMX and alternative agents are ceftazidime, chloramphenicolB. cepacia is the cause of a rapidly fatal syndrome of respiratory distress & septicemia ('cepacia syndrome')in cystic fibrosis Patients.Predisposing factors: cystic fibrosis & chronic granulomatous diseaseaB. cepacia inhabits moist environments and is found in rhizosphere.possesses multiple virulence factors & colonizing factors capable of binding to lung mucus (predilection of B.cepacia for the lungs in cystic fibrosis).Treatment:DOC for B. cepacia: TMP-SMXAlternative agents: Meropenem & doxycycline