Table 1 Timeline of the patient’s diagnosis and treatment
Date | Time | Events |
|---|---|---|
Day 0 | Morning | The patient experienced sudden illness, fell, and subsequently lapsed into a coma. |
12:31 | The patient was taken to the emergency room. | |
13:05 | Blood samples were collected for blood culture (bilateral double bottle). | |
13:12 | Head CT examination was performed. | |
13:52 | Imipenem was intravenously infused as empirical medication. | |
17:46 | The patient was transferred to the ICU. | |
19:11 | Meropenem was intravenously infused as empirical medication. | |
Day 1 | 9:56 | Intravenous meropenem infusion was continued as empirical medication. |
10:03 | Wound secretions were collected for bacterial culture. | |
10:43 | According to the clinical microbiology laboratory report, four blood culture bottles tested positive for Gram-negative bacteria. | |
14:33 | According to the clinical microbiology laboratory report, P. multocida was present in the blood culture samples. | |
16:32 | The initial dose of penicillin G 3.2 million units + 0.2 g oral doxycycline was administered. | |
Day 2 | 2:01 | The subsequent dose of penicillin G 3.2 million units + 0.1 g oral doxycycline was administered. |
8:00 | CSF was collected for bacterial culture and NGS detection. | |
Evening | The NGS results of CSF revealed 14,235 sequences of P. multocida genes. | |
Day 3 | 7:50 | Intravenous infusion of 2 g of ceftriaxone sodium was initiated. |
8:52 | The clinical microbiology laboratory released the drug sensitivity results of P. multocida. | |
12:14 | The patient underwent CSF replacement. | |
16:37 | Intravenous drip of 2 g of ceftriaxone sodium was continued. | |
Day 4 | 17:00 | The clinical microbiology laboratory revealed the drug sensitivity results of P. multocida cultured from the patient’s wound secretions. |
Day 5 | 9:38 | The clinical microbiology laboratory detected no pathogenic bacteria in the CSF after 3 days of cultivation. |