TY - JOUR
T1 - Unusual case of non-resolving necrotizing pneumonia
T2 - A last resort measure for cure
AU - Salahuddin, Naseem
AU - Baig-Ansari, Naila
AU - Fatimi, Saulat Hasnain
N1 - Publisher Copyright:
© 2016, Pakistan Medical Association. All rights reserved.
PY - 2016/6
Y1 - 2016/6
N2 - To our knowledge, this is an unusual case of a communityacquired pneumonia (CAP) with sepsis secondary to Streptococcus pneumoniae that required lung resection for a non-resolving consolidation. A 74 year old previously healthy woman, presented with acute fever, chills and pleuritic chest pain in Emergency Department (ED). A diagnosis of CAP was established with a Pneumonia Severity Index CURB-65 score of 5/5. In the ER, she was promptly and appropriately managed with antibiotics and aggressive supportive therapy. She remained on ten days of intravenous antibiotics. However, 48 hours post antibiotic course, she returned to ER with fever and signs of sepsis. Despite timely and appropriate management, the consolidated lobe remained the focus of sepsis for over four weeks. The patient recovered after the offending lobe was resected. Histopathology of the lung tissue revealed acute and chronic inflammation. However, no malignancy, bacterial infection or broncho-pleural fistula was found. Eighteen months post-surgery, the patient remains well.
AB - To our knowledge, this is an unusual case of a communityacquired pneumonia (CAP) with sepsis secondary to Streptococcus pneumoniae that required lung resection for a non-resolving consolidation. A 74 year old previously healthy woman, presented with acute fever, chills and pleuritic chest pain in Emergency Department (ED). A diagnosis of CAP was established with a Pneumonia Severity Index CURB-65 score of 5/5. In the ER, she was promptly and appropriately managed with antibiotics and aggressive supportive therapy. She remained on ten days of intravenous antibiotics. However, 48 hours post antibiotic course, she returned to ER with fever and signs of sepsis. Despite timely and appropriate management, the consolidated lobe remained the focus of sepsis for over four weeks. The patient recovered after the offending lobe was resected. Histopathology of the lung tissue revealed acute and chronic inflammation. However, no malignancy, bacterial infection or broncho-pleural fistula was found. Eighteen months post-surgery, the patient remains well.
KW - Community-acquired pneumonia
KW - Lung resection
KW - Necrotizing pneumonia
KW - Nonresolving pneumonia
KW - Strep pneumoniae
UR - http://www.scopus.com/inward/record.url?scp=84970023628&partnerID=8YFLogxK
M3 - Article
C2 - 27339583
AN - SCOPUS:84970023628
SN - 0030-9982
VL - 66
SP - 754
EP - 756
JO - Journal of the Pakistan Medical Association
JF - Journal of the Pakistan Medical Association
IS - 6
ER -