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Short Communication Volume 14 Issue 1
Timeline of infection and sepsis in a major burn patient with AKI on CRRT
David de Souza Gomez, Mauro Jorge Santos, Thais Vieira de Camargo, Karina Brandt Vianna, Aline Sandre Gomides Abad, Gabriela Aparecida Ferreira, Thiago Câmara de Oliveira, Maria Severina dos Santos, Nilo José Coelho Duarte, Paschoalina Romano, Persio de Almeida Rezende Ebner, Nairo Massakaku Sumita, Débora Cristina Sanches Pinto, Edvaldo Vieira de Campos, Elson Mendes da Silva Junior, João Manoel da Silva Jr, Silvia R C J Santos
Received: January 02, 2026 | Published: January 16, 2026
Citation: Gomez DS, Santos MJ, Camargo TV, et al. Timeline of infection and sepsis in a major burn patient with AKI on CRRT. Pharm Pharmacol Int J. 2026;14(1):6-10. DOI: 10.15406/ppij.2026.14.00486
Abstract
Introduction: In extended ICU stays for severe burn patients, beta-lactam de-escalation in Gram-negative infections is routinely used to prevent resistance. Candida spp. and yeast invasive infections are also common due to immunosuppression. Objective: To assess anidulafungin’s effectiveness against invasive fungal infections in immunosuppressed burn patient, and report ciprofloxacin efficacy against Pseudomonas aeruginosa (meropenem-and amikacin-resistant) on Day 41 of ICU admission in a septic burn patient with AKI receiving CRRT. Methodology: Approved by the hospital’s Ethics Committee (Brazilian Platform 07525118.3.0000.0068), this case involved a 31-year-old male (160 kg, 171 cm) with severe burns (25% TBSA), multiple injuries, and morbid obesity following an engine explosion at work. Admitted to ICU, he had a SAPS*3 score of 61/49% risk of death and Sofa 9. Results: The patient experienced severe oil burns, necessitating multiple surgical interventions. The complexity of infections and complications led to a prolonged hospital stay. Burn patients are at high risk for invasive infections due to factors such as underlying conditions, burn extent (TBSA), delays in wound excision, and pathogen characteristics. Diagnosing burn wound infections is complex because the responsible organisms depend on time from injury and location. Common pathogens include Staphylococcus and Pseudomonas species; fungal infections like Candida sepsis also occur. In this case, the patient had an invasive Fusarium solani infection, complicating recovery. The patient’s severe oil burns required several surgeries, including evisceration of the left-eye, resulting in a prolonged hospital stay due to infection complexity. Conclusion: Antibiotic therapy was adjusted based on infections and resistance, with TDM and MIC results guiding treatment selection. Pharmacokinetic monitoring ensured therapeutic drug levels. Fungal infections were treated with anidulafungin. Culture became negative by ICU Day 51 following ciprofloxacin and anidulafungin therapy. Precision medicine, using real-time anti-infective serum monitoring and culture results, enabled effective dosing adjustments and was crucial in treating multi-drug-resistant infections and improving outcomes in major burn patients.
Keywords: ICU immunosuppression and prolonged stay, major burn sepsis, inflammatory biomarkers, invasive fungal infections, anti-infectives TDM/MIC data & PK/PD
©2026 Gomez, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.