Case ReportsSuccessful Treatment of Severe Pneumonia Caused by Burkholderia cenocepacia With Intravenous Antibiotics and Immunosuppression Under Extracorporal Membrane OxygenationKirschbaum, Andreas MD*; Seyfer, Perla MD†; Hug, Martin J. PhD‡; Trittler, Rainer PhD‡; Pehl, Annika MD§; Koczulla, Andreas-Rembert MD∥; Holland, Angelique MD∥; Vogelmeier, Claus MD∥; Wulf, Hinnerk MD¶; Vassiliou, Timon MD¶; Rolfes, Caroline MD¶Author Information *Department of Visceral, Thoracic and Vascular Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany; †Department of Diagnostic and Interventional Radiology, UKMG Marburg, Germany; ‡Pharmacy, University Medical Center Freiburg, Freiburg, Germany; §Department of Pathology of Pneumology, UKGM, Marburg, Germany; ∥Department of Pneumology, UKGM, Marburg, Germany; and ¶Department of Anesthesiology and Critical CareMedicine, Marburg; Germany. Correspondence to: Caroline Rolfes, MD, Department of Anesthesiology and Critical Care Medicine, University Hospital Giessen and Marburg, Marburg, Baldingerstrasse, D-35033 Marburg, Germany. E-mail: Caroline.Rolfes@med.uni-marburg.de. The authors have no conflicts of interest to disclose. Infectious Diseases in Clinical Practice: January 2015 - Volume 23 - Issue 1 - p 54-56 doi: 10.1097/IPC.0000000000000208 Buy Metrics Abstract Purulent destruction–complicated pneumonia is a rare and serious disease of multifactorial genesis. In many cases, the diagnosis cannot be established by microbiological analysis of bronchial aspirates or transbronchial biopsies. In our present case, isolation of the pathogen was only possible by collecting specimens via open surgical lung biopsy. A 57-year-old otherwise healthy man was transferred to our department from another hospital. He presented with progressive respiratory failure while computed tomographic scan showed severe bilateral necrotising pneumonia. With open surgical lung biopsy, we could prove evidence of Burkholderia cenocepacia as causative pathogen. As the patient’s pulmonary condition deteriorated and he developed septic multiorgan failure, we initiated extracorporeal membrane oxygenation (ECMO) and commenced aggressive treatment with 4 intravenous antibiotics, cyclosporine, and corticosteroids. With this therapy, the patient’s situation rapidly improved; and he was successfully weaned from ECMO and mechanical ventilation. Pneumonia caused by B cenocepacia without underlying pulmonary disease such as cystic fibrosis is an absolute rarity. According to the severity of cepacia syndrome, an interdisciplinary approach including ECMO aggressive antibiotic treatment and immunosuppression was decisive for a successful therapy. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.