case_images: PMC11442429_01
case_images: Timeline of the clinical case's main events. Main medico-surgical events are represented as blue vertical arrows. Phage therapy-related events are represented in pink. Pink curve represents degree of Phage Immune Neutralization (PIN) against phage ISP in % of neutralized titer at 30 minutes. Error bars represent standard deviation of the means. Red droplets represent units (205 mL) of blood transfused. D , day; Sa, Staphylococcus aureus; Pa, Pseudomonas aeruginosa ; Sm, Stenotrophomonas maltophilia ; B, Blood culture ; R, Respiratory tract-originated sample culture (broncho-alveolar lavage or endotracheal aspirate) ; W, wound sample culture (swab or intraoperative biopsy); PT, phage therapy; IV, intravenous; PN, pulmonary nebulization; IP, intra-pleural; IA, intra-abdominal; CTX, Cefotaxime; FLX, Flucloxacillin; CLN, Clindamycin; VAN, Vancomycin; CPT, Ceftaroline; MEM, Meropenem; CIP, Ciprofloxacin; CST, Colistin.
case_images: fcimb-14-1354681-g001.jpg
case_images: PMC11442429_01_fcimb-14-1354681-g001.jpg
case_images: f1
case_images: A 12-year-old boy with no significant medical or surgical history was transferred (D0) to the Pediatric Intensive Care Unit (PICU) ( Figure 1 ). Despite these adapted standard-of-care (SOC) measures and in-range therapeutic drug monitoring of vancomycin within 48h of initiation, the infection rapidly progressed to generalized necrotizing fasciitis and pyomyositis on D+2, as confirmed by full-body MRI ( Figure 1 ).