Sue Come or Ella. Say what?

Posted by Shannon Hough at Friday, September 25, 2009

As a consult team, the pediatric infectious disease team sees many patients with complex infectious illnesses. Additionally, as a tertiary care center, Mott Children’s Hospital treats children with complicated medical problems. This month, many of the young patients we've seen were under some variety of precautions invoked by infection control. As a result, we would have to wear gloves or masks/gowns in order to enter the patient rooms.

Johnny was not one of those kids. He was being hospitalized for an infection in a central line. (Central lines are catheters used to deliver long-term IV medications into a central vein.) When we rounded, he was not usually in his room. He was running around the floor playing video games or hanging out in the playroom. This was not typical of the patients we had been seeing all month.

As with most patients with infections, Johnny was placed on empiric antibiotics that would treat the infections he was likely to have. Many times this includes multiple medications. Once we knew what pathogen was causing Johnny’s infection, we would be able to tailor his therapy specifically. A few days later, the microbiology lab informed our team that it was able to grow a bacteria from Johnny’s blood, but was not able to identify the gram negative rods. The bacteria was eventually identified by the State Department of Health as a species of Tsukamurella (pronounced: Sue-Come-Or-Ella). My immediate reaction was "What in the world is Tsukamurella?"

Even if I knew every single thing I had been taught in pharmacy school (which I don’t), I would have no idea how to treat a Tsukamurella infection. In this case, I did what any good pharmacist would do: I LOOKED IT UP! That's one of the things that makes the field of pharmacy so exciting. New bugs, drugs, and diseases are always being discovered. Treatment guidelines change. Thus, it is possible that the treatment protocols we learn in school today will not offer the best solutions a few years from now. But no matter what the advances in the medical sciences may be, knowing how to use investigative resources, and possessing a drive for lifelong learning are qualities that define a good pharmacist.

Image from: http://surgery.med.umich.edu/pediatric/clinical/patient_content/a-m/broviac_placement.shtml)