In view of the rising issue of multi-drug resistance (MDR), it is crucial to obtain proper blood and urine cultures if a febrile illness persists for a few days.
A 25-year-old female with no significant past medical history or comorbidities was admitted with a febrile illness lasting 10 days.
Initial tropical infection work-up was negative. While awaiting culture reports, the patient was started on carbapenem since she had already been treated with cephalosporins and quinolones. However, fever persisted with progressive thrombocytopenia and hypotension.
Further evaluation revealed that urine culture was positive for MDR E. coli. The patient was then switched to Colistin, and she showed immediate improvement in less than 24 hours, with stabilization of clinical condition and increased platelet counts—suggesting urosepsis.
Without a proper culture-based diagnosis, it would not have been possible to initiate appropriate antibiotics like Colistin, especially in a young patient with no comorbidities.
Inadvertent and improper use of antibiotics in the community may be leading to the development of resistant infections, necessitating a more judicious and evidence-based approach to antibiotic use.
