Management of necrotizing pneumonia with bronchopleural fistula caused by multidrug ‐resistant Acinetobacter baumannii

This report highlights our approach and management for patients with severe NP caused by multidrug ‐resistant microorganisms including timing to perform surgery and choice of antimicrobial treatment. AbstractWe report the case of a 53 ‐year‐old male that presented to our hospital with a history of a brain tumour. He was hospitalized 10 days prior in another hospital. Before surgery, he complained of mild cough. Routine chest radiography demonstrated right upper lobe consolidation which was diagnosed as hospital‐acquired p neumonia. Broad‐spectrum empirical antimicrobial was initiated. After surgery, his clinical condition deteriorated and he felt breathlessness. Chest radiography and computed tomography (CT) scan without contrast revealed necrotizing and cavitating pneumonia complicated by bronchopleural fistula (B PF) and hydropneumothorax. Sputum culture revealed infection of multidrug‐resistantAcinetobacter baumannii (MDRAB). Despite optimal antibiotic therapy, BPF and hydropneumothorax failed to resolve and surgical approach was performed to debride the necrotic area and seal the fistula. After a month in the hospital, he was discharged and the serial chest X ‐ray showed good recovery of the lung.
Source: Respirology Case Reports - Category: Respiratory Medicine Authors: Tags: Case Report Source Type: research