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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 57-year-old patient with HAP and a 67-year-old patient with HCAP. Chest radiography (A) and computed tomography (B) images of 57-year-old patient with HAP show infiltration shadow mainly in left upper lung field. Those (C and D) of 67-year-old with HCAP show infiltration shadow mainly in left lower lung field.
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fig2: Chest radiography and computed tomography images of a 57-year-old patient with HAP and a 67-year-old patient with HCAP. Chest radiography (A) and computed tomography (B) images of 57-year-old patient with HAP show infiltration shadow mainly in left upper lung field. Those (C and D) of 67-year-old with HCAP show infiltration shadow mainly in left lower lung field.

Mentions: A physical examination revealed a temperature of 37.1 °C, blood pressure of 120/80 mmHg and crackles (rhonchi) in the left lung. Chest radiography indicated infiltration shadows in the left lung field (Fig. 2(A) and (B)). Her initial WBC count was 720/L because she was under chemotherapy, and CRP was 16.4 mg/dL. P. aeruginosa determined in blood cultures and respiratory specimens was susceptible to meropenem, ciprofloxacin and gentamicin but resistant to piperacillin. Intravenous meropenem (3 × 1 g/day) for 14 days followed by cefepime (3 × 1 g/day) for 10 days improved the chest X-ray findings and the pneumonia.


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 57-year-old patient with HAP and a 67-year-old patient with HCAP. Chest radiography (A) and computed tomography (B) images of 57-year-old patient with HAP show infiltration shadow mainly in left upper lung field. Those (C and D) of 67-year-old with HCAP show infiltration shadow mainly in left lower lung field.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

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

fig2: Chest radiography and computed tomography images of a 57-year-old patient with HAP and a 67-year-old patient with HCAP. Chest radiography (A) and computed tomography (B) images of 57-year-old patient with HAP show infiltration shadow mainly in left upper lung field. Those (C and D) of 67-year-old with HCAP show infiltration shadow mainly in left lower lung field.
Mentions: A physical examination revealed a temperature of 37.1 °C, blood pressure of 120/80 mmHg and crackles (rhonchi) in the left lung. Chest radiography indicated infiltration shadows in the left lung field (Fig. 2(A) and (B)). Her initial WBC count was 720/L because she was under chemotherapy, and CRP was 16.4 mg/dL. P. aeruginosa determined in blood cultures and respiratory specimens was susceptible to meropenem, ciprofloxacin and gentamicin but resistant to piperacillin. Intravenous meropenem (3 × 1 g/day) for 14 days followed by cefepime (3 × 1 g/day) for 10 days improved the chest X-ray findings and the pneumonia.

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