Combined Use of Inhaled and Intravenous Colistin in a Patient with Acute Lymphoblastic Leukemia Complicated by Multi-Organ Failure and Sepsis: A Case Report.

Assema Bekniyazova 1, Aiman Maidan 2, Ivan Mishutin 3, Smanov Bakhytzhan 3, Gulfairus Yessenbayeva 4 *
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1 Department of Anesthesiology and Intensive Care, Astana Medical University, Astana, Kazakhstan
2 JSC Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
3 Oncohematology Intensive Care Unit, National Research Oncology Centre, Astana, Kazakhstan
4 Department of Anesthesiology, Intensive care and Hyperbaric oxygenation, Municipal Hospital №1, Astana, Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 22, Issue 3, pp. 93-97. https://doi.org/10.23950/jcmk/16366
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Author Contributions: Conceptualization, A. B.; methodology, A. B. and G. Y.; validation, A. M., I. M. D. and B. S.; formal analysis, G.  Y.; investigation, I. M., A. B. and B. C.; resources, I. M.; data curation, A. B.; writing – original draft preparation, A. B., B. S. and G. Y; writing – review and editing, G. Y. and A. M.; visualization, A. M.; supervision, G. Y., project administration, not applicable; funding acquisition, not applicable. All authors have read and agreed to the published version of the manuscript.

Data availability statement: The corresponding author can provide the data supporting the study's conclusions upon request. Due to ethical and privacy constraints, the data are not publicly accessible.

ABSTRACT

Sepsis and subsequent organ dysfunction are significant complications in patients with acute lymphoblastic leukemia (ALL). This case report details the successful use of combined inhaled and intravenous colistin in a 22-year-old male with high-risk ALL who developed tumor lysis syndrome, febrile neutropenia, respiratory failure, sepsis, septic shock, capillary leak, and prolonged mechanical ventilation requiring tracheostomy. Colistin inhalation was well-tolerated, delivered via a vibrating mesh nebulizer, and led to clinical improvement. This report contributes to the growing evidence supporting the role of inhaled colistin as an adjunct therapy in multidrug-resistant (MDR) infections and highlights its potential impact on antimicrobial stewardship in immunocompromised patients.
Keywords: colistin, sepsis, leukemia, multiple organ failure, case report.

CITATION

Bekniyazova A, Maidan A, Mishutin I, Bakhytzhan S, Yessenbayeva G. Combined Use of Inhaled and Intravenous Colistin in a Patient with Acute Lymphoblastic Leukemia Complicated by Multi-Organ Failure and Sepsis: A Case Report.. J CLIN MED KAZ. 2025;22(3):93-7. https://doi.org/10.23950/jcmk/16366

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