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CASE REPORT   

Minerva Pneumologica 2017 December;56(4):261-5

DOI: 10.23736/S0026-4954.17.01805-3

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

An unusual case of community acquired pneumonia in an immune competent host due to Pseudomonas Aeruginosa: an example of clinical management without hospitalization

Valentina CONTI 1 , Silvia RULI 2, Singora TONTI 2, Carlo RENZINI 2, Mei V. RULI 2, Sara STACCHINI 3, Marino GATTI 3, Emanuele D. CAPPELLA 4, Samanta MANONI 4, Gianfranco FANTINI 4, Enrico ROSSI 1

1 Pneumology Division, State Hospital, Borgo Maggiore, Republic of San Marino; 2 Departement of Geriatrics Care and Pneumology, State Hospital, San Marino, Republic of San Marino; 3 Radiology Unit, State Hospital, San Marino, Republic of San Marino; 4 Transfusion Medicine, Clinical Pathology and Microbiology Unit, State Hospital, San Marino, Republic of San Marino


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We present the case of a 49-year-old Caucasian, previously a healthy man with a community-acquired Pseudomonas Aeruginosa necrotizing pneumonia. The patient presented at our department with a 15-day history of right chest pain, fever and important episodes of smelly brownish sputum. The chest X ray image, confirmed by chest CT scan, revealed an excavated lesion in the right upper lobe. Immediately fiberoptic bronchoscopy was performed: bronchoalveolar lavage fluid was negative for mycobacteria tuberculosis and positive for Pseudomonas aeruginosa. Histological and cytological examination were negative for the presence of heteroplasia of the lung. The laboratory findings (including blood cultures and autoimmunity) showed only a slight increase of C-reactive protein, and an increase of erythrocyte sedimentation rate. The patient was prescribed clarithromycin at home for ten days and cefixime for thirty days. There was a prompt clinical and radiologic improvement. Pseudomonas aeruginosa is a rare cause of community-acquired pneumonia (CAP) in an immune competent host. Although rare in CAP, this type of infection should be considered in patients with severe rapidly progressive pneumonia.


KEY WORDS: Pseudomonas aeruginosa - Bronchoalveolar lavage - Mycobacterium

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