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日本呼吸器学会英文誌 Respiratory Investigation
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Abstract

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Article in Japanese

Case Report

A case of severe community-acquired pneumonia with septic shock and acute respiratory distress syndrome as a result of Pseudomonas aeruginosa in a healthy man

Akira Sasakia  Shigehisa Yanagia  Takehiko Naganob  Nobuhiro Matsumotoa  Hidenobu Ochiaib  Masamitsu Nakazatoa 

aDivision of Neurology, Respirology, Endocrinology, and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
bTrauma and Critical Care Center, Faculty of Medicine, University of Miyazaki

ABSTRACT

A heretofore healthy 57-year-old man developed left back pain and high fever 1 day ago. Based on findings of his chest X-ray, pneumonia was diagnosed, and intravenous administrations of ceftriaxone and minocycline were begun by a primary care physician. However, he progressed to septic shock and acute respiratory distress syndrome within 12 hours after commencement of the above treatment, and he was transferred to our hospital. Chest CT demonstrated consolidation with cavitation in the left upper lobe and ground-glass opacity and consolidation in both lung fields. Treatment with mechanical ventilation and administrations of dopamine and noradrenaline were undertaken. A Gram stain of sputum detected numerous Gram-negative bacilli, and we then changed the antimicrobial regimen to a combination treatment with meropenem and ciprofloxacin, which resulted in an improvement of his systemic conditions. All cultures from sputum and blood culture grew Pseudomonas aeruginosa with the identical profiles of antibiotic resistance patterns. P. aeruginosa community-acquired pneumonia (CAP) in previously healthy individuals is very rare, although it progresses rapidly and exhibits high lethality. P. aeruginosa should be considered as pathogenic bacteria in critically ill patients with CAP.

KEYWORDS

Pseudomonas aeruginosa  Community-acquired pneumonia  Septic shock  Acute respiratory distress syndrome (ARDS) 

Received 16 Jun 2014 / Accepted 20 Oct 2014

AJRS, 4(1): 110-115, 2015

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