Community-acquired Stenotrophomonas maltophilia respiratory infection in an octogenarian patient

Autor: P. López Pardo, C. Jiménez Rojas
Rok vydání: 2015
Předmět:
Zdroj: European Geriatric Medicine. 6:469-470
ISSN: 1878-7649
DOI: 10.1016/j.eurger.2015.07.002
Popis: The opportunistic pathogen Stenotrophomonas maltophilia (SM) is an aerobic, gram-negative, glucose non-fermenting bacillus, which is associated with nosocomial infections including pneumonia, bacteraemia, urinary tract infections, endocarditis, meningitis, peritonitis, and others. It is isolated from 3.3% of respiratory cultures and 0.8% of positive blood cultures [1]. It is ubiquitous in the environment, but due to its low virulence does not usually cause community-acquired infections in healthy individuals. Almost 80% of infections caused by SM are nosocomial [2]. Few cases of community-acquired SM respiratory infections are described in the literature, and none of them in patient older than 80 years of age [3]. We present the case of an 85-year-old woman who attended the emergency department due to progressive dyspnoea over the previous 4 days, with coughing, hyaline expectoration, a fever of 38 8C, and tachypnea. Her medical history included hypertension, type-2 diabetes mellitus, obesity, chronic obstructive pulmonary disease, and chronic renal insufficiency. She was being treated with furosemide, prednisone, fluticasone propionate/salmeterol xinafoate, tiotropium bromide, aspirine, omeprazole, and insulin. Her baseline situation was defined as dyspnoea with moderate exertion. Her mobility was limited after a recent lumbar vertebral compression (Barthel index 25/100). She lived with a 24-h carer and had no cognitive deficits. Laboratory analyses revealed leucocyte and neutrophil counts of 15,900 [4000–10,000] and 14,600 [1800–7500], respectively; C-reactive protein, 14.70 mg/dL [0–5]; haemoglobin, 9.4 g/dL [11.5–15]; glucose, 302 mg/dL [70–110]; creatinine, 1.97 mg/dL [0.5–0.9]. Blood arterial gas showed pO2/pCO2 48/58 mmHg; 83% O2 saturation; pH, 7.34. Chest X-ray showed a mass in the apical
Databáze: OpenAIRE
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