A 52 years old diabetic and asthmatic lady was admitted with a post-operative wound infection 10 days following removal of meningioma. The patient had a history of recurrent meningiomas for which she had undergone multiple surgeries during the past ten years. On admission, the patient was febrile and drowsy. There surgical wound site over the scalp was swollen, exuding a pussy discharge. Subsequently, a lumbar drain was inserted for CSF drainage, the yellowish discharge from the wound was sent for culture, which grew Streptococcus pyogenes for which I/V Ceftriaxone was started. The patient improved and remained stable till about the 25th day of hospital stay when she developed fever, chest infiltrates as well as copious pussy discharge from the wound. Due to rapid deterioration in patient`s condition she was shifted to ICU. Piperacillin tazobactam was started and lumbar drain was removed. The scalp wound was re-explored and a flap closure was done; an epidural drain was inserted for CSF drainage. As the patient did not improve clinically, all antibiotics were stopped and patient was rescreened for infection. One set of blood culture drown from a peripheral vein and the tip of pulmonary artery catheter grew Chryseomonas luteola. This organism was sensitive only to Ofloxacin and the patient`s antibiotic regimen was changed to Ofloxacin along with Aztreonam and Amikacin. The patient gradually improved on this regimen, was moved out of the ICU and subsequently managed in the ward.
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