Virulent Pseudomonas aeruginosa pneumonia in an immunocompetent adult associated with a home whirlpool bath: A case report

Yasumaro Fujiki; Naoko Mato; Shinya Watanabe; Tomoki Shibano; Ken Tonai; Kento Takahashi; Tatsuya Saito; Akiko Okuyama; Ayako Takigami; Masashi Bando; Takuji Suzuki; Longzhu Cui; Koichi Hagiwara

doi:10.1016/j.rmcr.2022.101673

Virulent Pseudomonas aeruginosa pneumonia in an immunocompetent adult associated with a home whirlpool bath: A case report

Respir Med Case Rep. 2022 Jun 2:38:101673. doi: 10.1016/j.rmcr.2022.101673. eCollection 2022.

Authors

Affiliations

¹ Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan.
² Division of Bacteriology, School of Medicine, Jichi Medical University, Tochigi, Japan.
³ Division of General Thoracic Surgery, Department of Surgery, Jichi Medical University, Tochigi, Japan.
⁴ Division of Intensive Care, Department of Anesthesiology & Intensive Care Medicine, Jichi Medical University, Tochigi, Japan.
⁵ Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.

Abstract

We present a case of life-threatening pneumonia caused by Pseudomonas aeruginosa (P. aeruginosa) in a healthy 67-year-old man. Rapid disseminated infection resulted in the right hemorrhagic pneumonia and bacteremia. Antimicrobial therapy had limited effects, radical pneumonectomy eventually resolved the prolonged infection. Concurrently, we explored the environmental factors responsible for fulminant P. aeruginosa infection. Multi-locus sequence typing demonstrated that P. aeruginosa isolated from the patient was identical to that collected from home whirlpool bath by the common virulent factor gene. Massive inhalation of contaminated aerosol and pathogen virulence may have synergistically contributed to the severity in this case.

Keywords: Exo S; Exoenzyme S (exoS) gene; Multi-locus sequence typing (MLST); Pseudomonas aeruginosa (P. aeruginosa); Whirlpool bath.

Publication types

Case Reports