1887

Abstract

Introduction:

community‐acquired pneumonia is an extremely rare clinical presentation but has been recognized in anecdotal reports, even in previously healthy patients.

Case presentation:

We describe a previously healthy man who developed community‐acquired pneumonia (CAP). He died of septic shock with rapidly progressive pulmonary consolidation in the right upper lobe (RUL). We reviewed the literature for CAP and identified 19 patients of whom 85 % ( = 17) had cavitations and/or consolidations in the RUL. We found that the odds ratio for death of shock at initial presentation was 8.333 ( = 0.046, 95 % confidence interval 1.034–67.142). We also found that CAP should be considered when individuals present with rapidly expanding cavitary pneumonia and/or consolidations in the RUL accompanied by septic shock, even if they have no known severe underlying disease and were previously healthy.

Conclusion:

We showed here that radiological findings of CAP, such as cavitary pneumonia and/or consolidation in the RUL, might be a clinical clue to a diagnosis of CAP as well as the presence of septic shock.

Loading

Article metrics loading...

/content/journal/jmmcr/10.1099/jmmcr.0.000281
2014-06-01
2019-10-14
Loading full text...

Full text loading...

/deliver/fulltext/jmmcr/1/2/jmmcr000281.html?itemId=/content/journal/jmmcr/10.1099/jmmcr.0.000281&mimeType=html&fmt=ahah

References

  1. Baltch A.L. , Griffin P.E. . ( 1977; ). Pseudomonas aeruginosa bacteremia: a clinical study of 75 patients. . Am J Med Sci 274:, 119–129.[CrossRef]
    [Google Scholar]
  2. Cirigliano M.D. , Grippi M.A. . ( 1994; ). Overwhelming pneumonia in a healthy young nursing assistant. . Hosp Pract (Off Ed) 29:, 1 31–34.
    [Google Scholar]
  3. Crnich C.J. . ( 2003; ). Hot tub‐associated necrotizing pneumonia due to Pseudomonas aeruginosa. . Clin Infect Dis 36:, 3 e55–57.[CrossRef]
    [Google Scholar]
  4. Fishman H. . ( 1983; ). Primary Pseudomonas pneumonia in a previously healthy man. . South Med J 76:, 2 260–262.[CrossRef]
    [Google Scholar]
  5. Govan J. . ( 1977; ). Pseudomonas pneumonia with bacteraemia. . Med J Aust 1:, 17 627–628.
    [Google Scholar]
  6. Gupta S. , Koirala J. , Khardori R. , Khardori N. . ( 2007; ). Infections in diabetes mellitus and hyperglycemia. . Infect Dis Clin North Am 21:, 617–638. [CrossRef]
    [Google Scholar]
  7. Harris A.A. . ( 1984; ). Community‐acquired Pseudomonas aeruginosa pneumonia associated with the use of a home humidifier. . West J Med 141:, 4 521–523.
    [Google Scholar]
  8. Hatchette T.F. . ( 2000; ). Pseudomonas aeruginosa community‐acquired pneumonia in previously healthy adults: case report and review of the literature. . Clin Infect Dis 31:, 6 1349–1356.[CrossRef]
    [Google Scholar]
  9. Hatchette T.F. , Gupta R. , Marrie T.J. . ( 2000; ). Pseudomonas aeruginosa community‐acquired pneumonia in previously healthy adults: case report and review of the literature. . Clin Infect Dis 31:, 1349–1356.[CrossRef]
    [Google Scholar]
  10. Henderson A. . ( 1992; ). Fulminant primary Pseudomonas aeruginosa pneumonia and septicaemia in previously well adults. . Intensive Care Med 18:, 7 430–432.[CrossRef]
    [Google Scholar]
  11. Hoogwerf B.J. , Khan M.Y. . ( 1981; ). Community‐acquired bacteremic Pseudomonas pneumonia in a health adult. . Am Rev Respir Dis 123:, 1 132–134.
    [Google Scholar]
  12. Huhulescu S. . ( 2011; ). Fatal Pseudomonas aeruginosa pneumonia in a previously healthy woman was most likely associated with a contaminated hot tub. . Infection 39:, 3 265–269.[CrossRef]
    [Google Scholar]
  13. Hyslop J.R. , Wallace T.I. . ( 1971; ). Primary Pseudomonas pneumonia. . Tex Med 67:, 11 112–115.
    [Google Scholar]
  14. Ishihara S. . ( 1995; ). Septic shock due to Pseudomonas aeruginosa in a previously healthy woman. . Intensive Care Med 21:, 3 226–228.[CrossRef]
    [Google Scholar]
  15. Ishihara S. , Takino M. , Okada Y. , Mimura K. . ( 1995; ). Septic shock due to Pseudomonas aeruginosa in a previously healthy woman. . Intensive Care Med 21:, 226–228.[CrossRef]
    [Google Scholar]
  16. Knapp S. . ( 2013; ). Diabetes and infection: is there a link? A mini‐review. . Gerontology 59:, 99–104.[CrossRef]
    [Google Scholar]
  17. Kunimasa K. . ( 2012; ). Successful treatment of fulminant community‐acquired Pseudomonas aeruginosa necrotizing pneumonia in a previously healthy young man. . Intern Med 51:, 17 2473–2478.[CrossRef]
    [Google Scholar]
  18. Leroy O. , Bosquet C. , Vandenbussche C. , Coffinier C. , Georges H. , Guery B. , Alfandari S. , Thevenin D. , Beaucaire G. . ( 1999; ). Community‐acquired pneumonia in the intensive care unit: epidemiological and prognosis data in older people. . J Am Geriatr Soc 47:, 539–546.[CrossRef]
    [Google Scholar]
  19. Nathan D.M. , Kuenen J. , Borg R. , Zheng H. , Schoenfeld D. , Heine R.J. . A1c‐Derived Average Glucose Study Group ( 2008; ). Translating the A1C assay into estimated average glucose values. . Diabetes Care 31:, 1473–1478.[CrossRef]
    [Google Scholar]
  20. Okada F. , Ono A. , Ando Y. , Nakayama T. , Ishii R. , Sato H. , Kira A. , Tokimatsu I. , Kadota J. , Mori H. . ( 2012; ). Thin‐section CT findings in Pseudomonas aeruginosa pulmonary infection. . Br J Radiol 85:, 1533–1538.[CrossRef]
    [Google Scholar]
  21. Okamoto M. . ( 2012; ). Successful treatment of a previously healthy woman with Pseudomonas aeruginosa community‐acquired pneumonia with plasmapheresis. . Intern Med 51:, 19 2809–2812.[CrossRef]
    [Google Scholar]
  22. Pennington J.E. , Reynolds H.Y. , Carbone P.P. . ( 1973; ). Pseudomonas pneumonia. A retrospective study of 36 cases. . Am J Med 55:, 155–160.[CrossRef]
    [Google Scholar]
  23. Quirk J.A. . ( 1990; ). Community‐acquired pseudomonas pneumonia in a normal host complicated by metastatic panophthalmitis and cutaneous pustules. . Aust N Z J Med 20:, 3 254–256.[CrossRef]
    [Google Scholar]
  24. Rose H.D. . ( 1983; ). Pseudomonas pneumonia associated with use of a home whirlpool spa. . JAMA 250:, 15 2027–2029.[CrossRef]
    [Google Scholar]
  25. Rose H.D. , Franson T.R. , Sheth N.K. , Chusid M.J. , Macher A.M. , Zeirdt C.H. . ( 1983; ). Pseudomonas pneumonia associated with use of a home whirlpool spa. . JAMA 250:, 2027–2029.[CrossRef]
    [Google Scholar]
  26. Sadikot R.T. , Blackwell T.S. , Christman J.W. , Prince A.S. . ( 2005; ). Pathogen–host interactions in Pseudomonas aeruginosa pneumonia. . Am J Respir Crit Care Med 171:, 1209–1223.[CrossRef]
    [Google Scholar]
  27. Shaulov A. . ( 2011; ). A 44‐year‐old man with cavitary pneumonia and shock. . Neth J Med 69:, 9 402.406.
    [Google Scholar]
  28. Torres A. , Menendez R. . ( 2010; ). Enterobacteriaceae and Pseudomonas aeruginosa in community‐acquired pneumonia: the reality after a decade of uncertainty?. . Eur Respir J 35:, 473–.474.[CrossRef]
    [Google Scholar]
  29. Vikram H.R. . ( 1999; ). Community acquired Pseudomonas aeruginosa pneumonia. . Conn Med 63:, 5 271–273.
    [Google Scholar]
  30. Williams B.J. , Dehnbostel J. , Blackwell T.S. . ( 2010; ). Pseudomonas aeruginosa: host defence in lung diseases. . Respirology 15:, 1037–1056.[CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmmcr/10.1099/jmmcr.0.000281
Loading
/content/journal/jmmcr/10.1099/jmmcr.0.000281
Loading

Data & Media loading...

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error