Atypical pneumonia in an immunocompromised host
Keywords:Lung cancer, Opportunistic infections, Pneumonia
Pneumonia is a common complication of patient with lung cancer. Various Pathogens have been reported to cause pneumonia in such patients, commonly involved organisms include bacteria (e.g. S. pneumoniae, Klebsiella spp., P. aeruginosa, S. aureus), virus (e.g. CMV, varicella zoster virus, respiratory syncytial virus, parainfluenza and influenza viruses), fungi (e.g. histoplasmosis, cryptococcosis, pneumocystosis, Aspergillosis), opportunistic infections (e.g. Aspergillus, Pneumocystis jiroveci) and this list is progressively growing. Here authors are going to discuss a rare case of 61-year-old male patient of lung cancer suffering from pneumonia caused by Chryseobacterium gleum, Stenotrophomonas maltophilia and Actinomyces naeslundii and its management. Since these organisms are rarely known to cause pneumonia, so whenever we encounter such patients while authors consider common pathogens, authors should also keep in mind rare organisms especially when the pt fail to respond standard treatment.
Corti M, Palmero D, Eiguchi K. Respiratory infections in immunocompromised patients. Curr Opin Pulm Med. 2009 May 1;15(3):209-17.
Kirby JT, Sader HS, Walsh TR, Jones RN. Antimicrobial susceptibility and epidemiology of a worldwide collection of Chryseobacterium spp.: report from the SENTRY Antimicrobial Surveillance Program (1997-2001). J Clin Microbiol. 2004 Jan 1;42(1):445-8.
Vishnu T, Soniyamby A, William A, Abhinand R, Praveesh B. A mini review of an opportunistic pathogen-Chryseobacterium sp. World J Pharm Pharma Sci. 2014;3:599-605.
Brooke JS. Stenotrophomonas maltophilia: an emerging global opportunistic pathogen. Clin Microbiol Rev. 2012 Jan 1;25(1):2-41.
Valour F, Sénéchal A, Dupieux C, Karsenty J, Lustig S, Breton P, et al. Actinomycosis: etiology, clinical features, diagnosis, treatment, and management. Infec Drug Resis. 2014;7:183.
Chang YT, Lin CY, Chen YH, Hsueh PR. Update on infections caused by Stenotrophomonas maltophilia with particular attention to resistance mechanisms and therapeutic options. Front Microbiol. 2015 Sep 2;6:893.
Wei C, Ni W, Cai X, Zhao J, Cui J. Evaluation of trimethoprim/sulfamethoxazole (SXT), minocycline, tigecycline, moxifloxacin, and ceftazidime alone and in combinations for SXT-susceptible and SXT-resistant Stenotrophomonas maltophilia by in vitro time-kill experiments. PLoS One. 2016;11(3).
Denton M, Kerr KG. Microbiological and clinical aspects of infection associated with Stenotrophomonas maltophilia. Clin Microbiol Revi. 1998 Jan 1;11(1):57-80.
Mabeza GF, Macfarlane J. Pulmonary actinomycosis. Eur Respi J. 2003 Mar 1;21(3):545-51.