1/78. Community acquired pseudomonas aeruginosa pneumonia.pseudomonas aeruginosa is an uncommon cause of community acquired pneumonia in immunocompetent hosts. We report two cases that did well once appropriate and prolonged antimicrobial therapy was initiated. They had no evidence of immune deficiency. The initial consideration was pulmonary tuberculosis in both cases given the subacute presentation, significant weight loss, and findings on chest roentgenogram.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
2/78. Treatment of nosocomial pneumonia and tracheobronchitis caused by multidrug-resistant pseudomonas aeruginosa with aerosolized colistin.Gram-negative bacilli including multidrug-resistant (MDR) pseudomonas aeruginosa are responsible for a significant proportion of episodes of nosocomial pneumonia. Since the development of new antibiotics with activity against gram-negative organisms has not kept pace with the increase in prevalence of MDR pathogens, there has been renewed interest in antimicrobial agents that had previously been used but had been abandoned because of toxic side effects. This report describes three patients with nosocomial pneumonia or tracheobronchitis due to multiresistant strains of P. aeruginosa for whom aerosolized colistin proved beneficial as supplemental therapy. Aerosolized colistin merits further consideration as a therapeutic intervention for patients with pulmonary infections due to MDR P. aeruginosa.- - - - - - - - - - ranking = 1.2keywords = pneumonia (Clic here for more details about this article) |
3/78. pseudomonas aeruginosa community-acquired pneumonia in previously healthy adults: case report and review of the literature.We report a case of rapidly fatal pseudomonas aeruginosa community-acquired pneumonia (CAP) in a previously healthy 67-year-old woman. Eleven published case reports of P. aeruginosa CAP in previously healthy adults are reviewed. According to our review, the mean age of affected patients is 45.3 years. Five patients described in the literature were smokers with a mean smoking history of 40 pack-years. The clinical presentation is nonspecific, and although the pneumonia can be rapidly fatal, only 33% of the patients who were reported died. However, mortality may be independent of treatment within the first 36 hours of presentation. Exposure to aerosols of contaminated water is a risk factor for P. aeruginosa CAP in this population. Pseudomonas CAP should be considered in the differential diagnosis for anyone with a smoking history who presents with rapidly progressive pneumonia. We discuss treatment recommendations that are based on evidence in the currently available literature on the subject.- - - - - - - - - - ranking = 1.4keywords = pneumonia (Clic here for more details about this article) |
4/78. Disseminated pseudomonas aeruginosa and necrotizing pneumonia with complete recovery.pseudomonas aeruginosa pneumonia and recovery with treatment are rare in healthy individuals. We report the case of a 59-year-old man with P aeruginosa skin infection and sepsis, later giving rise to necrotizing pneumonia by hematogenous spread. He responded to prolonged intensive care and 3 weeks of piperacillin-tazobactam and tobramycin therapy. There was no evidence of immunosuppression other than that caused by alcoholism in this unusual case. The resulting cavity healed completely by fibrosis in 1 year.- - - - - - - - - - ranking = 1.2keywords = pneumonia (Clic here for more details about this article) |
5/78. Aerosolized amikacin in the treatment of Pseudomonas pneumonia in the nursing home setting.Studies have shown that aerosolized aminoglycosides represent a safe and effective means of treating pneumonia due to Pseudomonas sp. Aerosolized aminoglycosides have been shown to improve clinical outcome, with less risk of nephrotoxicity relative to parenteral aminoglycosides. Apparently, less drug resistance is associated with the use of aerosolized aminoglycosides. Cost factors favor aerosolized delivery methods. The full recovery experienced by the patient in this case study suggests that aerosolized amikacin may be a safe, efficacious, and cost-effective means of treating pseudomonal pneumonia in geriatric patients. Controlled clinical trials should be conducted to further investigate this treatment regimen.- - - - - - - - - - ranking = 1.2keywords = pneumonia (Clic here for more details about this article) |
6/78. Low flow veno-venous ECMO via subclavian dialysis catheter for severe respiratory failure.BACKGROUND: We present the case of a 12-year-old female with severe postoperative bacterial pneumonia unresponsive to conventional treatment following a failed renal transplant. CASE REPORT: The patient was placed on low flow veno-venous extracorporeal membrane oxygenation (ECMO) as an adjuvant treatment to antibiotic therapy and maximal ventilatory support. Venous ECMO resulted in rapid improvement and the patient was successfully weaned after 48 hours of circulatory assistance. Two days later, the patient was extubated and safely discharged from the intensive care unit. Eighteen months later, she remains stable on peritoneal dialysis and is awaiting a new donor kidney. CONCLUSIONS: Low flow veno-venous ECMO represents a new therapeutic alternative for critically ill patients whose condition does not meet the conventional ECMO criteria. Further clinical experience is still needed.- - - - - - - - - - ranking = 0.2keywords = pneumonia (Clic here for more details about this article) |
7/78. Continuous beta-lactam antibiotic therapy in a double-lung transplanted patient with a multidrug-resistant pseudomonas aeruginosa infection.BACKGROUND: It is well known that the bactericidal effect of beta-lactam antibiotics is closely related to the time which the serum concentration of the antibiotic remains above the minimal inhibitory concentration of the target pathogen. Thus, the optimal administration of beta-lactam antibiotics would be the continuous infusion of the drug. methods: We present a case report with a critically ill double-lung transplanted patient with pneumonia due to a multidrug-resistant pseudomonas aeruginosa who received continuously 8 g meropenem/24 hr. Based on a previous pharmacokinetic study showing that continuous infusion of meropenem is at least equivalent to intermittent administration this case report is reported to demonstrate the clinical efficacy of continuous infusion. RESULTS: c-reactive protein and pneumonia decreased rapidly when clinical conditions were improved significantly. Continuous administration of meropenem did not interfere with cyclosporine, no side effects were seen, and the patient's renal function was not impaired during the whole period of treatment. CONCLUSION: The continuous administration of beta-lactam antibiotics is a powerful application in critically ill patients to intensify antimicrobial therapy.- - - - - - - - - - ranking = 0.4keywords = pneumonia (Clic here for more details about this article) |
8/78. Usefulness of bronchoalveolar lavage for the diagnosis and treatment of refractory pneumonia in a patient with Kostmann syndrome, a severe congenital neutropenia.An 11-year-old girl with Kostmann syndrome developed refractory pneumonia. culture of oral discharge, throat-swab specimens, and blood could not identity the causative organism, and systemic antimicrobial therapy failed to achieve improvement. We then performed diagnostic bronchoalveolar lavage (BAL) and culture of BAL fluid (BALF) yielded pseudomonas aeruginosa. Therapeutic BAL using gentamicin produced a striking improvement of her pneumonia. Conclusion: In immunocompromised children with pneumonia, BAL helps to identify the causative organism. If the patient is unresponsive to systemic antimicrobial therapy, BAL using antimicrobial agents is also worth trying.- - - - - - - - - - ranking = 1.4keywords = pneumonia (Clic here for more details about this article) |
9/78. Postmenopausal tubo-ovarian abscess due to pseudomonas aeruginosa in a renal transplant patient: a case report and review of the literature.BACKGROUND: pseudomonas aeruginosa is an uncommon cause of infection in the female genital tract. We report a case of postmenopausal tubo-ovarian abscess (TOA) due to P. aeruginosa in a renal transplant recipient. The presentation included mild abdominal symptoms with rapid progression of peritonitis and surgical abscess drainage. This is the first such case in an organ transplant recipient described in the English literature. methods AND RESULTS: Published reports of 1040 cases of TOA were reviewed. The most common features were a history of sexually transmitted disease or pelvic inflammatory disease, and symptoms including abdominal pain and fever. escherichia coli, bacteroides spp., and klebsiella pneumoniae were the most frequently encountered pathogens. neisseria gonorrhoeae and chlamydia trachomatis, which are frequently isolated from cervical cultures, are uncommonly isolated from tubo-ovarian abscesses. Forty percent of patients were treated with antibiotics alone, 18.8% with abdominal surgery, and 32% with surgery and antimicrobial therapy. CONCLUSION: This report illustrates the muted presentation and atypical microbiology of gynecologic infection in an organ transplant recipient.- - - - - - - - - - ranking = 0.2keywords = pneumonia (Clic here for more details about this article) |
10/78. Respiratory colonization with Pseudomonas putrefaciens after near-drowning in salt water.Pseudomonas putrefaciens, a marine organism infrequently found in human culture material, was repeatedly isolated from the sputum of a patient with pneumonia during a three-week period following a salt-water drowning accident. Similar organisms were found in the water at the site of the accident in boston, and at ocean bathing beaches on nearby Martha's Vineyard.- - - - - - - - - - ranking = 0.2keywords = pneumonia (Clic here for more details about this article) |
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