Septic shock secondary to an acute necrotizing community-acquired pneumonia with bacteremia due to Pseudomonas aeruginosa

Abstract

Pseudomonas aeruginosa is an uncommon cause of necrotizing acute community-acquired pneumonia (CAP). Only thirteen cases have been previously reported in the literature. In this article, we describe a case of previously healthy 80-year-old male patient, who presented in septic shock caused by necrotizing CAP. Despite inadequate empiric antimicrobial treatment, the patient survived and was able to return to his home after three weeks of hospitalization. To the best of our knowledge, this is the second case of septic shock secondary to P. aeruginosa necrotizing CAP and bacteremia, with optimal clinical outcome. We highlight the evolution of this pathology remains unpredictable, despite the factors related to the host and the bacterium.

Keywords: Pseudomonas aeruginosa; cavity lesion; community-acquired pneumonia; septic shock.

Fig. 1

Comparison of chest imaging: A) Anteroposterior Chest X-ray at admission: infiltration of the right upper lobe associated with a cavity. B) Computed tomography (CT) of thorax without contrast at admission: consolidation associated with cavitation. C) Anteroposterior Chest X-ray after 14 days of antibiotic therapy: significant decrease of pulmonary consolidation and presence of a residual cavity of 10 cm diameter.