Mohd Rozita, Nesam Theepa, Kamaruzaman Lydia, Cader Rizna Abdul, Mustafar Ruslinda, Kong Wei-Yen
Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Respir Med Case Rep. 2018 May 17;24:147-149. doi: 10.1016/j.rmcr.2018.05.019. eCollection 2018.
is an aerobic Gram-negative coccobacillus that is associated with hospital acquired pneumonia. There is increased reporting of emergent cases of community acquired multidrug resistance (MDR) associated with a higher mortality due to antibiotic resistance. Community acquired MDR pneumonia has not been reported in Malaysia. Here we report a case of a 19-year-old army officer who presented with fever and respiratory symptoms for 5 days. He had no known medical illness before and no history of hospitalization. Upon arrival, he was in septicaemic shock, requiring invasive ventilator support and renal replacement therapy in intensive care unit. Chest radiograph showed bilateral lung consolidations and bronchoscopy revealed haemoserous and greenish bronchiole secretion. He was treated with broad spectrum antibiotics and oseltamivir. Unfortunately he died on day 3 of hospital admission. His bronchial lavage culture came back positive for MDR . This case illustrates that clinicians need to be aware that MDR can cause severe community acquired pneumonia. We may need to consider this diagnosis in patients who do not respond to standard therapy.
是一种需氧革兰氏阴性球杆菌，与医院获得性肺炎相关。社区获得性多重耐药（MDR）的新发病例报告有所增加，因其抗生素耐药性导致死亡率更高。马来西亚尚未报告社区获得性MDR肺炎。在此，我们报告一例19岁陆军军官的病例，该患者出现发热和呼吸道症状5天。他之前无已知病史，也无住院史。入院时，他处于败血症性休克状态，在重症监护病房需要有创呼吸机支持和肾脏替代治疗。胸部X光片显示双侧肺部实变，支气管镜检查显示有血性浆液性和绿色的细支气管分泌物。他接受了广谱抗生素和奥司他韦治疗。不幸的是，他在入院第3天死亡。他的支气管灌洗培养结果显示MDR呈阳性。该病例表明临床医生需要意识到MDR可导致严重的社区获得性肺炎。对于对标准治疗无反应的患者，我们可能需要考虑这一诊断。
