Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Jan 15;58(2):301-305.
doi: 10.2169/internalmedicine.0787-18. Epub 2018 Sep 12.

Severe Community-acquired Pneumonia Caused by Acinetobacter baumannii Successfully Treated with the Initial Administration of Meropenem Based on the Sputum Gram Staining Findings

Yurika Iwasawa  1 , Naoto Hosokawa  2 , Mariko Harada  1 , Satoshi Hayano  2 , Akihiko Shimizu  2 , Daisuke Suzuki  2 , Kei Nakashima  3 , Makito Yaegashi  1
Affiliations
Case Reports

Severe Community-acquired Pneumonia Caused by Acinetobacter baumannii Successfully Treated with the Initial Administration of Meropenem Based on the Sputum Gram Staining Findings

Yurika Iwasawa et al. Intern Med. .

Abstract

A 62-year-old man with diabetes mellitus and a two-day history of fever and dyspnea presented at our hospital. He was diagnosed with community-acquired pneumonia (CAP), septic shock, and respiratory failure. Sputum Gram staining revealed Gram-negative coccobacilli. Based on the Gram staining findings and history, Acinetobacter baumannii was considered as one of the causative organisms of his CAP. Consequently, he was successfully treated with the initial administration of meropenem. We suggest that A. baumannii should be considered as one of the possible causative organisms of CAP based on a fulminant clinical course, and the presence of Gram-negative coccobacilli.

Keywords: Acinetobacter; Acinetobacter baumannii; Gram stain; community-acquired pneumonia; empiric therapy.

PubMed Disclaimer

Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure 1.
Figure 1.
Chest X-ray and computed tomography on admission. Chest X-ray shows infiltrative shadow from the right upper and middle lung lobes (A). Computed tomography shows consolidation with air bronchogram in right upper (B) and middle (C) lobes. Lobar consolidation is often seen in Acinetobacter baumannii-induced community-acquired pneumonia.
Figure 2.
Figure 2.
Image of a Gram stain of sputum on admission. (Gram stain; ×1,000) This stain shows large, round gram-negative coccobacilli in the form of either single cocci or diplococci.
Figure 3.
Figure 3.
Chest computed tomography scan on day 13. Consolidation with multiple small cavities and a low attenuation area in the right upper lobe, supporting the necrotizing pneumonia are observed (5, 13, 14).
Figure 4.
Figure 4.
Clinical course. MEPM: meropenem, AZM: azithromycin, ABPC/SBT: ampicillin/sulbactam, CFPM: cefepime, CPFX: ciprofloxacin, WBC: white blood cell count, CRP: C reacting protein, CPAP: continuous positive airway pressure, PS: pressure support, NHF: nasal high flow
See this image and copyright information in PMC

References

    1. Munoz-Price LS, Weinstein RA. Acinetobacter Infection. N Engl J Med 358: 1271-1281, 2008. - PubMed
    1. Koshimizu N, Sato M, Gemma H, Uemura K, Chida K. An autopsy case of fulminant community-acquired pneumonia due to Acinetobacter baumannii. Kansenshogaku Zasshi (Journal of Japanese association for Infectious disease) 83: 392-397, 2009(in Japanese, Abstract in English). - PubMed
    1. Morioka H, Matsumoto S, Kojima E, Takada K, Shizu M, Okachi S. A case of fulminant community-acquired Acinetobacter pneumonia in a healthy woman. Nihon Kokyuki Gakkai Zasshi (Journal of the Japanese respiratory society) 49: 57-61, 2011(in Japanese, Abstract in English). - PubMed
    1. Tanaka M, Asada M, Kanda A, et al. . Severe community-acquired pneumonia due to Acinetobacter baumannii. Nihon Kokyuki Gakkai Zasshi (Journal of the Japanese respiratory society) 49: 760-764, 2011(in Japanese, Abstract in English). - PubMed
    1. Davis JS, McMillan M, Swaminathan A, et al. . A 16-year prospective study of community-onset bacteremic Acinetobacter pneumonia: low mortality with appropriate initial empirical antibiotic protocols. Chest 146: 1038-1045, 2014. - PubMed

Publication types

MeSH terms