Successful treatment of breakthrough bacteremia due to Pseudomonas aeruginosa with recombinant human granulocyte colony-stimulating factor in a patient with acute leukemia.

Bacteremia remains a veritable scourge for patients with hematologic malignancy undergoing intensive chemotherapy1). Patients with profound granulocytopenia are most likely to develop persistent or recurrent bacteremia despite appropriate antibiotic therapy2•`4), that is, breakthrough bacteremia2). Most patients whose granulocyte counts increase during the course of the infection, however, have a substantially better prognosis3,5,6). Recent studies7,8 have confirmed that treatment with recombinant human granulocyte colony-stimulating factor (rhG-CSF) accelerates recovery from chemotherapy-induced granulocytopenia. We describe here a case of breakthrough bacteremia with Pseudomonas aeruginosa, which was successfully treated with the short-term addition of rhG-CSF to antipseudomonal antibiotics, during the treatment of a patient with acute leukemia.