Case Report Community-acquired Pseudomonas aeruginosa pneumonia in previously healthy patients

Department of Laboratory Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa,Mitaka City, Tokyo, JapanIntroduction: Pseudomonas aeruginosa community-acquired pneumonia is an extremely rareclinical presentation but has been recognized in anecdotal reports, even in previously healthypatients.Case presentation: We describe a previously healthy man who developed P. aeruginosacommunity-acquired pneumonia (CAP). He died of septic shock with rapidly progressivepulmonary 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/orconsolidations in the RUL. We found that the odds ratio for death of shock at initial presentationwas 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 cavitarypneumonia and/or consolidations in the RUL accompanied by septic shock, even if they have noknown severe underlying disease and were previously healthy.Conclusion: We showed here that radiological findings of P. aeruginosa CAP, such as cavitarypneumonia and/or consolidation in the RUL, might be a clinical clue to a diagnosis of CAP as wellas the presence of septic shock.Keywords: Pseudomonas aeruginosa; cavity; community-acquired pneumonia; septic shock.