Hussain Khandakar M, Alam Md Didar Ul, Ahmad Nuzhat T
Internal Medicine, Conemaugh Memorial Medical Center, Johnstown, USA.
Internal Medicine, Sylhet MAG Osmani Medical College, Sylhet, BGD.
Cureus. 2021 Mar 1;13(3):e13632. doi: 10.7759/cureus.13632.
A 56-year-old male was admitted to the hospital with severe sepsis secondary to pneumonia. His presentation was challenging and confusing due to the accompanying coronavirus disease 2019 (COVID-19) infection attributed to his travel history and diagnosed via radiological findings. He received dexamethasone with ceftriaxone and azithromycin. Despite the fact he was on appropriate antibiotics, his condition worsened, and he was eventually diagnosed with Legionella pneumonia, which was thought to be resistant to macrolides. His condition improved significantly when antibiotics were switched to levofloxacin. It is important to keep in mind other causes of community-acquired pneumonia (CAP) during the ongoing COVID-19 era. What makes this case unique is that it presented a confusing scenario due to the patient's concurrent COVID-19 infection and his failure to improve with the administration of azithromycin.
一名56岁男性因肺炎继发严重脓毒症入院。由于其旅行史导致感染2019冠状病毒病（COVID-19），并经影像学检查确诊，其临床表现具有挑战性且令人困惑。他接受了地塞米松联合头孢曲松和阿奇霉素治疗。尽管他使用了适当的抗生素，但其病情仍恶化，最终被诊断为军团菌肺炎，据认为该菌对大环内酯类耐药。当抗生素换为左氧氟沙星后，他的病情显著改善。在当前COVID-19流行时期，牢记社区获得性肺炎（CAP）的其他病因很重要。该病例的独特之处在于，由于患者同时感染COVID-19且使用阿奇霉素治疗后病情未改善，呈现出一种令人困惑的情况。
