Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, Republic of China.
BMC Infect Dis. 2019 Feb 8;19(1):130. doi: 10.1186/s12879-019-3765-1.
Pseudomonas aeruginosa is an unusual pathogen in community-acquired pneumonia, especially in previously healthy adults, but often indicates poor prognosis.
We report a previously healthy patient who developed severe community-acquired pneumonia (CAP) caused by P. aeruginosa. He deteriorated to septic shock and multiple organ dysfunction syndrome (MODS) quickly, complicated by secondary hematogenous central nervous system (CNS) infection. After 1 month of organ support and antipseudomonal therapy, he had significant symptomatic improvement and was discharged from hospital. During treatment, the pathogen developed resistance to carbapenems quickly and the antibiotic regimen was adjusted accordingly.
According to our case and related literature review, we conclude that more attention should be paid to community-acquired Pseudomonas aeruginosa pneumonia, because of its rapid progression and poor prognosis.
铜绿假单胞菌是社区获得性肺炎（尤其是在既往健康的成年人中）的一种罕见病原体，但常提示预后不良。
我们报告了一例既往健康的患者，其发生由铜绿假单胞菌引起的严重社区获得性肺炎（CAP）。他迅速发展为感染性休克和多器官功能障碍综合征（MODS），并继发血源性中枢神经系统（CNS）感染。在器官支持和抗假单胞菌治疗 1 个月后，他的症状显著改善并出院。在治疗过程中，病原体对碳青霉烯类药物迅速产生耐药性，因此相应地调整了抗生素方案。
根据我们的病例和相关文献复习，我们得出结论，对于社区获得性铜绿假单胞菌肺炎，应更加关注，因为其进展迅速且预后不良。
