Community‐acquired Pseudomonas aeruginosa pneumonia in previously healthy patients

Abstract

Introduction: Pseudomonas aeruginosa community-acquired pneumonia is an extremely rare clinical presentation but has been recognized in anecdotal reports, even in previously healthy patients.Case presentation: We describe a previously healthy man who developed P. aeruginosa community-acquired pneumonia (CAP). He died of septic shock with rapidly progressive pulmonary consolidation in the right upper lobe (RUL). We reviewed the literature for P. aeruginosa CAP and identified 19 patients of whom 85 % (n517) had cavitations and/or consolidations in the RUL. We found that the odds ratio for death of shock at initial presentation was 8.333 (P50.046, 95 % confidence interval 1.034-67.142). We also found that P. aeruginosa CAP should be considered when individuals present with rapidly expanding cavitary pneumonia and/or consolidations in the RUL accompanied by septic shock, even if they have no known severe underlying disease and were previously healthy. Conclusion:We showed here that radiological findings of P. aeruginosa CAP, such as cavitary pneumonia and/or consolidation in the RUL, might be a clinical clue to a diagnosis of CAP as well as the presence of septic shock.