Objectives
▣Acinetobacter baumannii (AB)
- Gram-negative coccobacillus
- isolated only from infected patients,
or from the hospital environment during outbreaks
- important cause of hostpital-acquired pneumonia(HAP)
- multiple drug resistance isolates
- a few reports of community-acquired AB pneumonia,
in patients with comorbidities in tropical or subtropical areas
▣Community-acquired AB pneumonia
- fulminant course,
with an acute onset of dyspnea,
cough,
fever,
productive cough and tachypnea that rapidly progress to respiratory failure and shock.
- high mortality rate (40 to 64%)
( higher than the overall...
Materials and Methods
▣We identified 36 patients with culture-proven AB pneumonia over a 3-year period through the computerized infectious disease database .▣Hosptial acquired pneumonia (n=28)▣Sex: Male-Female ratio 20:8▣Age : 31-94 years,
median age 72.2 years
▣Community acquired pneumonia (n=8)▣Sex: Male-Female ratio 3:5▣Age : 58-86 years,
median age 71.9 years▣We retrospectively reviewed clinical history,
initial chest radiographs and CT scans and follow-up simple radiograph imaging findings of eight patients with community-acquired AB pneumonia.▣Patterns at CT
- focal consolidation
- multifocal consolidation
- ground-glass opacity
- branching centrilobular nodular opacity...
Results
▣Chest radiographs
▣Bilateral patchy alveolar opacities: 5 patients
▣Focal alveolar opacity: 2 patients
▣Large loculated pleural effusion: 1 patient
▣CT
▣Bilateral multifocal consolidations: 4 patients
▣Patchy ground glass opacity: 3 patients
▣Patchy peribronchial small branching nodular opacities: 1 patient
▣Pleural effusion: 3 patients (1 patient: pleural empyema)
▣Reactive mdiastinal nodes: 3 patients
▣In 4 patients,
rapid progression of diffuse parenchymal opacities suggesting ARDS was observed on serial radiographs within a week.
▣Almost all of the patients(7 of 8 patients; 88%) had underlying chronic illness,
including...
Conclusions
▣Bilateral patchy consolidation and ground glass opacities were the most common findings of community-acquired AB pneumoniaon chest ragiograph and CT.
Rapid progression of the consolidation to involve the whole lung fields within a week was notedin 4 patients among 8 patients ofcommunity-acquired Acinetobacter pneumonia.
▣Although these findings are not specific for AB pneumonia and the incidence of community-acquired AB pneumonia is low,
AB pneumonia should be included in the possible cause of pneumonia when rapid progression of pneumonia is observed in elderly patients with underlying...