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Community-acquired, hospital-acquired, and healthcare-associated pneumonia caused by Pseudomonas aeruginosa.

Fujii A, Seki M, Higashiguchi M, Tachibana I, Kumanogoh A, Tomono K - Respir Med Case Rep (2014)

Bottom Line: Piperacillin was initially effective, but fever and lobular pneumonia with cavities developed seven days after discharge.Healthcare-associated pneumonia (HCAP) was diagnosed and effectively treated with tobramycin and ciprofloxacin.P. aeruginosa is not only a causative pathogen of HAP and HCAP, but possibly also of CAP.

View Article: PubMed Central - PubMed

Affiliation: Division of Infection Control and Prevention, Osaka University, Suita City, Osaka, Japan ; Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University, Suita City, Osaka, Japan.

ABSTRACT
We describe three types of Pseudomonas aeruginosa pneumonia. Case 1. P. aeruginosa was isolated from the blood and sputum of a 29-year-old male non-smoker who developed severe community-acquired pneumonia (CAP). Piperacillin was initially effective, but fever and lobular pneumonia with cavities developed seven days after discharge. Intravenous piperacillin/tazobactam and tobramycin were administered for four weeks, followed by oral ciprofloxacin for two weeks. He finally recovered, but developed recurrent CAP due to P. aeruginosa despite appropriate antibiotic therapy and immunocompetent status. Case 2. P. aeruginosa was isolated from the blood and sputum of a 57-year-old woman with renal cancer who developed hospital-acquired pneumonia (HAP) after surgical treatment. She recovered after meropenem administration for four weeks. Case 3. A 67-year-old woman with systemic sclerosis and malignant lymphoma who was followed up on an outpatient basis underwent immunosuppressive therapy. Thereafter, she developed pneumonia and was admitted to our institution where P aeruginosa was isolated from blood and sputum samples. Healthcare-associated pneumonia (HCAP) was diagnosed and effectively treated with tobramycin and ciprofloxacin. P. aeruginosa is not only a causative pathogen of HAP and HCAP, but possibly also of CAP.

No MeSH data available.


Related in: MedlinePlus

Chest radiography and computed tomography images of a 29-year-old patient admitted with CAP in June 2012 and August 2012. Chest radiography and computed tomography images in June 2012 (A and B, respectively) show patchy airspace opacity in right upper lung lobe. Those acquired in August 2012 (C and D, respectively) show right upper lobular pneumonia with cavity.
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fig1: Chest radiography and computed tomography images of a 29-year-old patient admitted with CAP in June 2012 and August 2012. Chest radiography and computed tomography images in June 2012 (A and B, respectively) show patchy airspace opacity in right upper lung lobe. Those acquired in August 2012 (C and D, respectively) show right upper lobular pneumonia with cavity.

Mentions: A physical examination indicated the following: temperature, 39.5 °C; blood pressure, 111/50 mmHg and a respiratory rate of 28 breaths/min. A physical examination revealed crackles (rhonchi) at the upper right lung and chest radiography indicated bilateral opacities (Fig. 1(A) and (B)). His initial WBC count was 26,400/L, and C-reactive protein (CRP) was 20.0 mg/dL. P. aeruginosa was identified in blood cultures and respiratory specimens and the minimum inhibitory concentration (MIC) test according to Clinical and Laboratory Standards Institute criteria revealed susceptibility to levofloxacin, piperacillin, ciprofloxacin and gentamicin. Rapid antigen tests for influenza A and B virus were negative. Intravenous piperacillin (4 × 3 g/day) for 19 days improved the chest X-ray findings and the inflammatory markers, WBC (8900/L) and CRP (0.9 mg/dL). Blood cultures also became negative. He was discharged from hospital after completing the course of treatment.


Community-acquired, hospital-acquired, and healthcare-associated pneumonia caused by Pseudomonas aeruginosa.

Fujii A, Seki M, Higashiguchi M, Tachibana I, Kumanogoh A, Tomono K - Respir Med Case Rep (2014)

Chest radiography and computed tomography images of a 29-year-old patient admitted with CAP in June 2012 and August 2012. Chest radiography and computed tomography images in June 2012 (A and B, respectively) show patchy airspace opacity in right upper lung lobe. Those acquired in August 2012 (C and D, respectively) show right upper lobular pneumonia with cavity.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061442&req=5

fig1: Chest radiography and computed tomography images of a 29-year-old patient admitted with CAP in June 2012 and August 2012. Chest radiography and computed tomography images in June 2012 (A and B, respectively) show patchy airspace opacity in right upper lung lobe. Those acquired in August 2012 (C and D, respectively) show right upper lobular pneumonia with cavity.
Mentions: A physical examination indicated the following: temperature, 39.5 °C; blood pressure, 111/50 mmHg and a respiratory rate of 28 breaths/min. A physical examination revealed crackles (rhonchi) at the upper right lung and chest radiography indicated bilateral opacities (Fig. 1(A) and (B)). His initial WBC count was 26,400/L, and C-reactive protein (CRP) was 20.0 mg/dL. P. aeruginosa was identified in blood cultures and respiratory specimens and the minimum inhibitory concentration (MIC) test according to Clinical and Laboratory Standards Institute criteria revealed susceptibility to levofloxacin, piperacillin, ciprofloxacin and gentamicin. Rapid antigen tests for influenza A and B virus were negative. Intravenous piperacillin (4 × 3 g/day) for 19 days improved the chest X-ray findings and the inflammatory markers, WBC (8900/L) and CRP (0.9 mg/dL). Blood cultures also became negative. He was discharged from hospital after completing the course of treatment.

Bottom Line: Piperacillin was initially effective, but fever and lobular pneumonia with cavities developed seven days after discharge.Healthcare-associated pneumonia (HCAP) was diagnosed and effectively treated with tobramycin and ciprofloxacin.P. aeruginosa is not only a causative pathogen of HAP and HCAP, but possibly also of CAP.

View Article: PubMed Central - PubMed

Affiliation: Division of Infection Control and Prevention, Osaka University, Suita City, Osaka, Japan ; Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University, Suita City, Osaka, Japan.

ABSTRACT
We describe three types of Pseudomonas aeruginosa pneumonia. Case 1. P. aeruginosa was isolated from the blood and sputum of a 29-year-old male non-smoker who developed severe community-acquired pneumonia (CAP). Piperacillin was initially effective, but fever and lobular pneumonia with cavities developed seven days after discharge. Intravenous piperacillin/tazobactam and tobramycin were administered for four weeks, followed by oral ciprofloxacin for two weeks. He finally recovered, but developed recurrent CAP due to P. aeruginosa despite appropriate antibiotic therapy and immunocompetent status. Case 2. P. aeruginosa was isolated from the blood and sputum of a 57-year-old woman with renal cancer who developed hospital-acquired pneumonia (HAP) after surgical treatment. She recovered after meropenem administration for four weeks. Case 3. A 67-year-old woman with systemic sclerosis and malignant lymphoma who was followed up on an outpatient basis underwent immunosuppressive therapy. Thereafter, she developed pneumonia and was admitted to our institution where P aeruginosa was isolated from blood and sputum samples. Healthcare-associated pneumonia (HCAP) was diagnosed and effectively treated with tobramycin and ciprofloxacin. P. aeruginosa is not only a causative pathogen of HAP and HCAP, but possibly also of CAP.

No MeSH data available.


Related in: MedlinePlus