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2017 ; 2017
(ä): 1717492
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Necrotizing Pseudomonas aeruginosa Community-Acquired Pneumonia: A Case Report
and Review of the Literature
#MMPMID28596927
Maharaj S
; Isache C
; Seegobin K
; Chang S
; Nelson G
Case Rep Infect Dis
2017[]; 2017
(ä): 1717492
PMID28596927
show ga
Lung cavities are not typically associated with community-acquired pneumonia
(CAP). CAP due to P. aeruginosa is rare and even less commonly causes necrotizing
pneumonia. We report a case of P. aeruginosa CAP that progressed to necrotizing
pneumonia and was eventually fatal. Procalcitonin (PCT) has been well
investigated in guiding antibiotic therapy (especially CAP) in adults. In this
case, PCT at presentation and sequentially was negative. We discuss this caveat
and present hypotheses as to the sensitivity and specificity of PCT and
C-reactive protein (CRP) in these patients. To better characterize P. aeruginosa
CAP, we undertook a review of cases indexed in PubMed from 2001 to 2016 (n = 9).
The data reveal that risk factors for P. aeruginosa CAP include smoking, alcohol
use, obstructive lung disease, sinusitis, and hot tub use. The route of infection
for P. aeruginosa CAP remains unknown. One of the most interesting findings on
reviewing cases was that P. aeruginosa CAP involves the right upper lobe in the
vast majority. We suggest that when physicians in the community see patients with
distinctly upper lobe necrotizing or cavitary pneumonia, they should consider P.
aeruginosa in their differential diagnosis. Further studies are needed to clarify
route of infection, role of PCT and CRP, and optimal therapy including drug and
duration.