Pseudomonas aeruginosa causing inflammatory mass of the nasopharynx in an immunocompromised HIV infected patient: A mimic of malignancy

Abstract

Head and neck manifestations of acquired immunodeficiency syndrome are among the most common complications of this disease. The sinonasal and oral manifestations are more common that the otologic and range from malignancies to infectious processes caused by both opportunistic and nonopportunistic organisms. We report the case of a nasopharyngeal mass of infectious etiology in a severely immunocompromised HIV infected patient. The patient was admitted with a presumptive diagnosis of infectious gastroenteritis and was found to have a nasopharyngeal mass. The mass was extending into the oropharynx and paravertebral soft tissues and was associated with extensive secretions causing near complete occlusion of the oropharynx. CT scan findings favored malignant verses infectious etiology. The surgical biopsy performed twice ruled out malignancy and the bacterial culture proved to be a pure growth of Pseudomonas aeruginosa. Pseudomonas can inhabit the nasopharynx and lower digestive tract, and is only occasionally associated with causing disease in non-susceptible patients but is a common infection in immunocompromised patients. To the best of our knowledge, and after considering the current literature, we believe this case is unique. We discuss this rare entity and its management. Clinicians should be aware of this potential life threatening condition in the HIV population and add P. aeruginosa infection to the differential diagnosis of an acute inflammatory nasopharyngeal mass.

Pseudomonas aeruginosa Biofilms

“…Pseudomonas aeruginosa is an ubiquitous Gram-negative bacterium that causes nosocomial infections, as well as fatal infections in immunocompromised individuals, such as patients with cancer, post-surgery, severe burns or infected by human immunodeficiency virus (HIV) [ 1 , 2 , 3 ]. In 2017, P. aeruginosa was recognised as one of the most life-threatening bacteria and listed as priority pathogen for Research and Development of new antibiotics by the World Health Organization [ 4 ].…”

Genome sequence of Pseudomonas aeruginosa PA1-Petro—A role model of environmental adaptation and a potential biotechnological tool

“…P. aeruginosa is a ubiquitous Gram-negative species of bacteria, commonly associated with nosocomial and opportunistic infections that can be fatal to immunocompromised patients, like cancer patients, patients with severe burns or infected with the human immunodeficiency virus (HIV) ( Gale et al., 2015 ; Gomila et al., 2018 ). P. aeruginosa is a dominant pathogen in people with cystic fibrosis (CF) contributing to morbidity and mortality.…”

A Pseudopaline Fluorescent Probe for the Selective Detection of Pseudomonas aeruginosa

“…aeruginosa, one of the ESKAPE pathogens and one of the top three "critical priority pathogens" on the World Health Organization (WHO) priority list, causes severe nosocomial infections, notably in immunocompromised patients. [40][41][42][43] P. aeruginosa infection is often difficult to treat due to its biofilm formation, making it escape most antimicrobial therapies and host immune responses. [44][45][46][47] Therefore, the development of P. aeruginosa-specific probes is urgently needed to diagnose its infection at an early stage, especially before it forms a biofilm.…”