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

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.