A case report of community-acquired Pseudomonas aeruginosa pneumonia complicated with MODS in a previously healthy patient and related literature review

Abstract

Background: Pseudomonas aeruginosa is an unusual pathogen in community-acquired pneumonia, especially in previously healthy adults, but often indicates poor prognosis.

Case presentation: We report a previously healthy patient who developed severe community-acquired pneumonia (CAP) caused by P. aeruginosa. He deteriorated to septic shock and multiple organ dysfunction syndrome (MODS) quickly, complicated by secondary hematogenous central nervous system (CNS) infection. After 1 month of organ support and antipseudomonal therapy, he had significant symptomatic improvement and was discharged from hospital. During treatment, the pathogen developed resistance to carbapenems quickly and the antibiotic regimen was adjusted accordingly.

Conclusions: According to our case and related literature review, we conclude that more attention should be paid to community-acquired Pseudomonas aeruginosa pneumonia, because of its rapid progression and poor prognosis.

Keywords: CAP; MODS; Pseudomonas aeruginosa.

Fig. 1

Chest CT on ICU admission (a, b: multiple nodular and patchy shadows in the right superior and inferior lobes); Repeat CT on Day 5 (c: scattered patches of low densities in the left hemisphere, d: multiple large consolidation areas, worse compared with previous imaging; suspicious multiple nodular shadows within the consolidation of right inferior lobe; mild pleural effusion in right lung)

Fig. 2

Microscopic exam of biopsy (a, × 400): hemorrhagic necrosis mixed with inflammatory exudates; chest CT before discharge (b):structural lung damage with remaining cavities