Exacerbation of bronchiectasis by Pseudomonas putida complicating COVID-19 disease: A case report

Abstract

Novel coronavirus infection presents with greater severity in individuals with comorbid chronic lung diseases. Bronchiectasis is an illness characterized by permanent enlargement of the airways, presenting with chronic cough and sputum production and vulnerability to lung infections. Bronchiectasis is not a common comorbid disease in patients with COVID-19 disease and bronchiectasis exacerbation rates were decreased during the pandemic. However, COVID-19 disease is associated with worse outcomes in patients with bronchiectasis and patients with bronchiectasis are more susceptible to SARS-CoV-2 infection development. Pseudomonas putida is an opportunistic pathogen, causing infections mostly in immunocompromised hosts and is not a frequent bacterial colonizer in patients with bronchiectasis. This present study reports a rare case of exacerbation of bronchiectasis by Pseudomonas putida complicating COVID-19 disease in an immunocompetent 70-year-old woman. Clinicians should be aware that SARS-CoV-2 infection is probably a precipitating factor of bronchiectasis exacerbation while bronchiectasis is a risk factor for greater severity of SARS-CoV-2 infection.

Keywords: bronchiectasis; coronavirus; disease exacerbation; immunocompetence; infection.

Figure 1

(A) On admission, chest X-ray shows bilateral lung infiltrates, mostly in the periphery of the left lung. (B) Chest X-ray on the 5th day shows worsening of infiltrates.

Figure 2

High resolution computed tomography of the chest. (A) Arrows show bilateral pulmonary infiltrates mostly with a peripheral subpleural distribution. (B and C) Arrows show bronchiectasis.