A 48-year-old male was admitted for acute necrotizing pancreatitis of severe etiology.
On the second day of admission, the patient was admitted to the intensive care unit (ICU) due to anuric acute renal failure, requiring renal replacement therapy throughout hospitalization.
A nasojejunal tube was placed to start enteral feeding early and avoid subsequent infections.
She's attached to her most of the hospitalization time, having her to replace her twice.
Radiological follow-up by computed tomography (CT) at four weeks showed the presence of a 20 cm maximum collection located in the pancreas plus a 2 small episode of pancreatic tail in the head.
The patient received serial antibiotic therapy for suspected pancreatic tissue infection with meropenem and later vancomycin for bacteremia secondary to femoral catheter-resistant Staphylococcus aureus infection.
In the seventh week after admission, when meropenem had already been suspended and received treatment with vancomycin, the patient had a clinical worsening with fever.
During this febrile episode an emergency analytical was performed which showed the presence of 12,160 leukocytes/ml with 70.1% neutrophils, hemoglobin 9 g/dl, platelets 4 76 x 106/L and pancreatic c-reactive protein 12 mg.
