• Users Online: 248
  • Print this page
  • Email this page


 
 
Table of Contents
LETTER TO EDITOR
Year : 2019  |  Volume : 21  |  Issue : 1  |  Page : 76-77

Community-acquired Pseudomonas aeruginosa pneumonia in a previously healthy young woman


1 Department of Chest Diseases, Prof. Dr. Türkan Akyol Chest Diseases Hospital, Bursa, Turkey
2 Department of Infectious Diseases and Clinical Microbiology, Prof. Dr. Türkan Akyol Chest Diseases Hospital, Bursa, Turkey

Date of Submission25-Apr-2018
Date of Decision22-Jul-2018
Date of Acceptance22-Jul-2018
Date of Web Publication30-Apr-2019

Correspondence Address:
Dr. Abdullah Simsek
Department of Chest Diseases, Prof. Dr. Türkan Akyol Chest Diseases Hospital, Bursa
Turkey
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejop.ejop_24_19

Rights and Permissions

How to cite this article:
Simsek A, Babalık M, Mor G&. Community-acquired Pseudomonas aeruginosa pneumonia in a previously healthy young woman. Eurasian J Pulmonol 2019;21:76-7

How to cite this URL:
Simsek A, Babalık M, Mor G&. Community-acquired Pseudomonas aeruginosa pneumonia in a previously healthy young woman. Eurasian J Pulmonol [serial online] 2019 [cited 2019 Jul 17];21:76-7. Available from: http://www.eurasianjpulmonol.com/text.asp?2019/21/1/76/257450



To the Editor,

Pseudomonas aeruginosa is a rare cause of community-acquired pneumonia (CAP) in an immunocompetent host. P. aeruginosa CAP is prone to develop septicemia, is often rapidly progressive.[1],[2] Mortality may be as high as 50%.[3] This report describes a case of P. aeruginosa CAP in a previously healthy woman.

A previously healthy 27-year-old-woman, a nonsmoker referred to our hospital with a 4-day history of cough, high fever, and dyspnea.

A pulmonary physical examination indicated the following: temperature, 38.5 C; blood pressure, 140/80 mmHg; pulse rate, 138 beats/min; and a respiratory rate of 44 breaths/min. Blood oxygen saturation level was 88%. A pulmonary physical examination revealed rales at the right lung. Chest radiograph indicated heterogeneous and homogeneous density in the all zones of the right lung. The initial abnormal serum laboratory findings were as follows: Hgb: 10.4 and elevated C-reactive protein at 201, 5 mg/L. She was admitted to the intensive care unit.

Moxifloxacin treatment was started empirically. Radiologic and clinical response was partial with this treatment. P. aeruginosa was isolated in the sputum. Blood cultures were negative. Antibiotherapy was changed to imipenem-cilastatin due to antibiogram, and the patient developed dramatic clinical, radiological, and laboratory response to this therapy.

P. aeruginosa is frequently found in soil, water, plants, and moist environments. Henderson et al. suggested that P. aeruginosa CAP should be suspected in any patient who has environmental risk factors and has Gram-negative bacilli seen on the Gram stain of the sputum sample, and who presents with pneumonia with overwhelming sepsis.[4]

Any lobe of the lung can be involved, but two-thirds of the patients experience involvement of the right upper lobe.[1],[5]

Initial empirical antibiotic treatment decision is controversial in previously healthy patients. Sibila et al. suggested that patients who received antipseudomonal antimicrobials within the first 48 h of admission were more likely to survive at 30 days.[3]

A physician should consider P. aeruginosa CAP in previously healthy individuals with critical clinical conditions and with right upper lobe infiltrations in the lung. It would be better to start empirical antimicrobial treatment against P. aeruginosa initially.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Hatchette TF, Gupta R, Marrie TJ. Pseudomonas aeruginosa community-acquired pneumonia in previously healthy adults: Case report and review of the literature. Clin Infect Dis 2000;31:1349-56.  Back to cited text no. 1
    
2.
Kıraklı C, Koca H, Uçar ZZ, Erbaycu AE, Özacar R. Fatal progression of Pseudomonas aeruginosa pneumonia in a health care worker. Turk Toraks Der 2010;11:134-7.  Back to cited text no. 2
    
3.
Sibila O, Laserna E, Maselli DJ, Fernandez JF, Mortensen EM, Anzueto A, et al. Risk factors and antibiotic therapy in P. aeruginosa community-acquired pneumonia. Respirology 2015;20:660-6.  Back to cited text no. 3
    
4.
Henderson A, Kelly W, Wright M. Fulminant primary Pseudomonas aeruginosa pneumonia and septicaemia in previously well adults. Intensive Care Med 1992;18:430-2.  Back to cited text no. 4
    
5.
Tsuji S, Saraya T, Tanaka Y, Makino H, Yonetani S, Araki K, et al. Community-acquired Pseudomonas aeruginosa pneumonia in previously healthy patients. JMMCR 2014;10:1-5.  Back to cited text no. 5
    




 

Top
 
  Search
 
    Similar in PUBMED
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
References

 Article Access Statistics
    Viewed103    
    Printed11    
    Emailed0    
    PDF Downloaded36    
    Comments [Add]    

Recommend this journal