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Case Reports
. 2023 May 29;15(5):e39668.
doi: 10.7759/cureus.39668. eCollection 2023 May.

A Diagnostic Quandary of Escherichia Coli Pneumonia: A Case Report and Literature Review

Venu M Ganipisetti  1 , Natasha Dudiki  2 , Anand Athavale  1
Affiliations
Case Reports

A Diagnostic Quandary of Escherichia Coli Pneumonia: A Case Report and Literature Review

Venu M Ganipisetti et al. Cureus. .

Abstract

Escherichia coli community-acquired pneumonia (CAP) is an under-recognized condition associated with higher mortality compared to the other well-studied causes of pneumonia. E. coli pneumonia is frequently associated with bacteremia. Despite the absence of abdominal or urinary symptoms, the infection may originate from an occult gastrointestinal (GI) source since it is a common commensal bacteria of the GI tract. Conditions related to extraintestinal pathogenic E. coli (ExPEC) are gaining attention, and there has been a trend toward the rise of pneumonia secondary to gram-negative bacteria. This presents a diagnostic stewardship dilemma in a patient with sepsis, E. coli bacteremia, and apparent pneumonia - to assume and treat for E. coli CAP or to look for a GI/genitourinary source which may, in turn, lead to incidental findings and further studies. We report a case of E. coli CAP in a 62-year-old patient and our approach regarding the treatment and imaging course.

Keywords: community-acquired pneumonia (cap); diabetes mellitus type 2; diverticulitis colon; e coli: escherichia coli; e. coli pneumonia; expec; gram negative pneumonia.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Chest X-ray showing bibasilar infiltrates.
Figure 2
Figure 2. CT abdomen showing abnormal inflammatory changes suggestive of diverticulitis in the colon.
CT: computed tomography
Figure 3
Figure 3. CT abdomen showing inflammatory changes in the colon.
CT: computed tomography
See this image and copyright information in PMC

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