Septic shock secondary to an acute necrotizing community-acquired pneumonia with bacteremia due to Pseudomonas aeruginosa

Rivière, Pierre; Patin, David; Delaporte, E.; Mahfoudi, H.; Lecailtel, Sylvain; Poher, F.; Villette, Pierre; Duclaux, J.; Jouault, P.; Brunin, Guillaume

doi:10.1016/j.idcr.2019.e00563

Cited by 4 publications

(4 citation statements)

References 12 publications

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“…9 Most of these cases shared some similar features, including rapid progression and severe complications. 4,6,7 In this case, a 67-year-old male with no previous systemic disease. The CT after admission showed the dense consolidation site in the right lung, accompanying by mediastinal and right hilar lymphadenopathy.…”

Section: Discussionmentioning

confidence: 92%

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Combination Therapy of Polymyxin B and Amikacin for Community-Acquired Pseudomonas aeruginosa Pneumonia with MODS in a Previously Healthy Patient: A Case Report

Wang¹,

Yun²,

Zhao³

et al. 2021

IDR

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Background: Pseudomonas aeruginosa (P. aeruginosa) is an uncommon but fatal causative pathogen for community-acquired pneumonia (CAP). Few case reports described the previously healthy individuals with CAP caused by P. aeruginosa. Case Presentation: A 67-year-old male farmer was referred to our hospital with a 6-day history of fever and shortness of breath. The radiologic findings revealed a dense consolidation site in the right lung, considering infection lesion, accompanying with mediastinal and right hilar lymphadenopathy. Sputum sample results showed P. aeruginosa and multidrugresistant Acinetobacter baumannii. The combination of polymyxin B and amikacin was given to him based on the lab results, the manifestations of the patient were alleviated and he returned to his home after a 35-day hospitalization. Conclusion:We need to keep close attention to community-acquired P. aeruginosa pneumonia due to its high mortality, further studies are needed to identify the infectious source, effective examination, and optimal therapy including medications and duration.

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Section: Discussionmentioning

confidence: 92%

“… 9 Most of these cases shared some similar features, including rapid progression and severe complications. 4 , 6 , 7 …”

Section: Discussionmentioning

confidence: 99%

Combination Therapy of Polymyxin B and Amikacin for Community-Acquired Pseudomonas aeruginosa Pneumonia with MODS in a Previously Healthy Patient: A Case Report

Wang¹,

Yun²,

Zhao³

et al. 2021

IDR

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“…Moreover, ATS/IDSA recommend that each acute care center should develop its own validated screening tools for methicillin-resistant S. aureus (MRSA) and Pseudomonas based on local risk factors identified by the stewardship team. Not including the immunocompromised, as per the European guidelines (2011), ATD/IDSA (2019) recommends a non-anti-pseudomonal beta-lactam, plus or minus a macrolide or respiratory fluoroquinolone, as empiric therapy for CAP, not covering MRSA and Pseudomonas aeruginosa (PA) [ 1 , 2 , 3 , 4 , 5 ]. In both immunocompetent and immunocompromised patients, empirical therapy has to be expanded beyond the core respiratory pathogens, such as MRSA and resistant gram-negative bacilli (including PA), when risk factors for drug-resistant organisms or opportunistic pathogens are present (such as previous hospitalization, exposure to a parenteral antibiotic in the last 90 days or previous cultures of MRSA or Pseudomonas from the airways) [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

A Fatal Case of Pseudomonas aeruginosa Community-Acquired Pneumonia in an Immunocompetent Patient: Clinical and Molecular Characterization and Literature Review

et al. 2023

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Rare cases of Pseudomonas aeruginosa community-acquired pneumonia (PA-CAP) were reported in non-immunocompromised patients. We describe a case of Pseudomonas aeruginosa (PA) necrotizing cavitary CAP with a fatal outcome in a 53-year-old man previously infected with SARS-CoV-2, who was admitted for dyspnea, fever, cough, hemoptysis, acute respiratory failure and a right upper lobe opacification. Six hours after admission, despite effective antibiotic therapy, he experienced multi-organ failure and died. Autopsy confirmed necrotizing pneumonia with alveolar hemorrhage. Blood and bronchoalveolar lavage cultures were positive for PA serotype O:9 belonging to ST1184. The strain shares the same virulence factor profile with reference genome PA01. With the aim to better investigate the clinical and molecular characteristics of PA-CAP, we considered the literature of the last 13 years concerning this topic. The prevalence of hospitalized PA-CAP is about 4% and has a mortality rate of 33–66%. Smoking, alcohol abuse and contaminated fluid exposure were the recognized risk factors; most cases presented the same symptoms described above and needed intensive care. Co-infection of PA-influenza A is described, which is possibly caused by influenza-inducing respiratory epithelial cell dysfunction: the same pathophysiological mechanism could be assumed with SARS-CoV-2 infection. Considering the high rate of fatal outcomes, additional studies are needed to identify sources of infections and new risk factors, along with genetic and immunological features. Current CAP guidelines should be revised in light of these results.

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“…Хронические заболевания, тяжелые травмы, иммуносупрессия, социально-демографические показатели (мужской пол, возраст старше 65 лет и др.) являются факторами риска развития сепсиса и септического шока [35,55]. Многоцентровое двенадцатилетнее (1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008) исследование B. Zuber и соавт.…”

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Topical issues of clinical symptoms and diagnostics of septic shock

Гоманова

Fokina

2022

Russian Journal of Infection and Immunity

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Currently, septic shock remains an unresolved public health problem that leads to serious epidemiological, economic and social problems. Septic shock is a common hemodynamic disorder caused by the interaction between pathogenic microbes and host cells, resulting in developing hypoxia, severe metabolic disorders and multiple organ failure. By now, no unified concept for pathophysiology of septic shock are available. However, the aforementioned data prove that one of the key arms in the pathogenesis is endothelial dysfunction and associated ischemic disorders. In the clinical course of septic shock, three stages are distinguished: the stage of compensation, decompensation as well as the stage of irreversible disorders. The initial stage, or the stage of compensation, is characterized by the activated inflammatory response against infectious agents. Clinically, this stage is characterized by the development of warm shock: fever, dermal hyperemia, hyperventilation, increased cardiac output, and tachycardia. The second stage in developing septic shock is characterized by arising cold shock as a consequence of escalating heart and respiratory failure. The final stage is the development of multiple organ failure manifested by emerging shock organs. Multiple organ failure occurs due to microthrombosis and increasing ischemia, which leads to hypoxia and development of mitochondrial dysfunction in immune cells. At this stage patients are characterized by the progressive cyanosis, developing anuria and intestinal obstruction, as well as altered mental status. Laboratory and instrumental diagnostics of septic shock is a promising approach to examine septic shock. The level of serum C-reactive protein, lactate, and proinflammatory cytokines are not highly specific diagnostic parameters of septic shock, because they can be found in any inflammatory process. Today, the promising diagnostic markers are pentraxin-3, high-density lipoproteins, and phosphatidylcholine. The severity of septic shock can be assessed by determining blood schistocytes, central venous pressure, and the ratio of venous-arterial CO2 and arterial-venous O2 pressure. The following diagnostic methods can be used to determine multiple organ failure: level of serum proenkephalin A119159 and heparin-binding protein; echocardiography, troponin I concentration and N-terminal pro-b-type natriuretic peptides; measuring activity of the renin-angiotensin-aldosterone system. Here we discuss the key aspects of pathogenesis, clinical picture and morphological changes of septic shock. The promising methods for diagnosing the disease and its complications have been studied.

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Septic shock secondary to an acute necrotizing community-acquired pneumonia with bacteremia due to Pseudomonas aeruginosa

Cited by 4 publications

References 12 publications

Combination Therapy of Polymyxin B and Amikacin for Community-Acquired Pseudomonas aeruginosa Pneumonia with MODS in a Previously Healthy Patient: A Case Report

Combination Therapy of Polymyxin B and Amikacin for Community-Acquired Pseudomonas aeruginosa Pneumonia with MODS in a Previously Healthy Patient: A Case Report

A Fatal Case of Pseudomonas aeruginosa Community-Acquired Pneumonia in an Immunocompetent Patient: Clinical and Molecular Characterization and Literature Review

Topical issues of clinical symptoms and diagnostics of septic shock

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