Pulmonary exacerbation of cistic fibrosis by Brevibacterium sp in a child: case report and literature review

Abstract

Cystic fibrosis (CF) is an autosomal recessive disease that usually affects the respiratory tract causing recurrent infections and deterioration of lung function. Other organs such as the digestive system and pancreas are also affected. In this report, we describe an 8-year girl with CF, previously colonized with Pseudomonas aeruginosa that developed pulmonary exacerbation not responsive to empiric treatment of broad spectrum antibiotics directed against prior colonization. Brevibacterium sp was detected in culture of bronchoalveolar lavage during bronchoscopy. Antimicrobial treatment was changed to vancomycin, meropenem, amikacin and ciprofloxacin with clinical, laboratorial and radiologic improvement after 23 days of treatment. Patient received discharge 30 days after admission for ambulatory follow-up. Its important that healthcare workers consider the possibility of atypical agents causing pulmonary exacerbation in patients with cystic fibrosis, mainly in children with initial failure of empiric treatment.