Severe pneumonia caused by complex bacterial infections: a case report and literature review / 中国基层医药

ABSTRACT

Objective:To investigate the diagnosis and treatment of severe pneumonia caused by unexplained complex infections by analyzing and summarizing the clinical data of one patient with severe pneumonia.Methods:We included one case of severe pneumonia who was cured in the Department of Critical Care Medicine of Anhui Provincial Cancer Hospital in 2018. We used descriptive methods to analyze the case data and reviewed pieces of literature related to clinical data collected during diagnosis and treatment.Results:The 34-year-old male patient had chest tightness and asthma attacks in December 2017. He received treatment in Departments of Respiratory Medicine and Critical Care Medicine, Class III Grade A hospitals outside Anhui Province. Chest CT scans showed atelectasis and consolidation of the right lung, and bilateral pleural effusion. Laboratory test results suggested widespread drug-resistant Acinetobacter baumannii, Aspergillus, and Candida infections. Cardiac color Doppler ultrasound images suggested pulmonary hypertension. He had recurrent respiratory failure. After mechanical ventilation, he had septic shock. These findings indicated severe pneumonia. Later, he was escorted by a 120 ambulance hospital transportation car from Guangzhou to the Department of Critical Care Medicine, Anhui Provincial Cancer Hospital to alleviate respiratory failure and shock. During hospitalization, the patient underwent nasal feeding because of an aspiration mistake. He was also subject to an active anti-infection, nutritional support, and airway management. The patient's condition improved, but respiratory failure could not be completely alleviated. After experimental anti-tuberculosis treatment, the patient was discharged because his condition improved. The patient was treated for a total of 102 days. Conclusion:A single pathogen or a single pathogenic factor is involved in community-acquired severe pneumonia in young and middle-aged patients. During diagnosis and treatment of severe pneumonia, laboratory test results have a guiding significance for judging the patient's condition. Diagnosis of severe pneumonia caused by unexplained complex infections does not simply rely on laboratory test results. Under the condition of infection by non-specific pathogens such as tuberculosis, severe pneumonia should be treated after analyzing clinical manifestations, asking the medical history in detail, carefully monitoring the changes in disease condition, paying attention to details, and finding the pathological factors.