Ventilator-associated pneumonia (VAP) is defined as pneumonia occurring in a patient after intubation with an endotracheal tube or tracheostomy tube lasting for 48 hours or more. We describe a case of 75-year-old male who initially presented with pneumonia of the right basis with accompanying plevritis. The patient was intubated and his condition was complicated with a VAP infection while he developed a lung abscess. The antibiotic therapy was based on susceptibility bronchial secretions isolated acinetobacter baumannii and klebsiella pneumoniae; these pathogens were also isolated from the drained abscess. The patient was discharged in good health. The interest of this case is recommended in the existence of two responsible pathogens, the paucity of the development of lung abscess in a patient with VAP, and the successful treatment of the patient with the combination of controlled drainage of the abscess and appropriate antibiotic therapy.

A 75-year-old male with a history of diabetes, heart failure and chronic obstructive pulmonary disease was admitted to hospital with a 2 days history of cough, fever (> 38 °C) and shortness of breath. Chest x-ray and chest CT revealed pneumonia of the right basis (Fig. 1). Under the diagnosis of community-acquired pneumonia, the administration of piperacillin-tazobactam (i.v. and nebulizer) was initially started. Nevertheless, the patient was intubated a few hours later due to hemodynamic instability and insufficient gas exchange. The antibiotic therapy was continued with no patient’s clinical improvement. Acinetobacter baumannii and klebsiella pneumoniae were isolated from the bronchial secretions and a new antibiotic i.v. scheme included meropenem and colistin was administrated; the scheme was based on his bronchial cultures susceptibility while the diagnosis of VAP was established.