Chest Infections: Fellow Case Report Poster - Chest Infections II |

Acinetobacter Baumanii Pneumonia in a Nonintubated Patient Who Presented With Flu-Like Symptoms FREE TO VIEW

Ishan Malhotra, MBBS; Hatem Desoky, MD; Chanaka Seneviratne, MD; Yizhak Kupfer, MD; Prarthna Chandar, MBBS; Mangalore Amith Shenoy, MBBS; Taek Yoon, MD; Shyam Shankar, MBBS; Pavan Irukulla, MBBS; Pavan Gorukanti, MD; Anand Kumar Rai, MBBS; Amit Agarwal, MD; Karan Wats, MBBS; Amogh Gajankush, MBBS
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Maimonides Medical Center, Brooklyn, NY

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):129A. doi:10.1016/j.chest.2016.08.138
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SESSION TITLE: Fellow Case Report Poster - Chest Infections II

SESSION TYPE: Affiliate Case Report Poster

PRESENTED ON: Tuesday, October 25, 2016 at 01:30 PM - 02:30 PM

INTRODUCTION: We report a case of a patient who presented with flu-like symptoms and was subsequently superinfected with Acinetobacter baumanii, a rare pathogen complicating seasonal influenza.

CASE PRESENTATION: A 61-year-old male patient with past medical history of diabetes presented to the emergency room with progressive worsening of shortness of breath over one week prior to presentation accompanied by flu- like symptoms. He was admitted to the intensive care unit and required treatment with high flow oxygen via nasal cannula to maintain adequate oxygenation. He was empirically treated with oseltamivir for suspected influenza and antibiotics to cover common community acquired secondary bacterial pathogens. The patient did not require intubation during his hospital stay. The initial respiratory cultures grew Acinetobacter baumanii which was multidrug resistant except to Polymyxin B and Tigecycline with which he was treated for 2 weeks and demonstrated improvement.

DISCUSSION: Acinetobacter baumanii is a gram negative coccobacillus organism which is known to cause multidrug resistant nosocomial infections worldwide (1). It's most common presentation is that of ventilator associated pneumonia. Community acquired infections with Acinetobacter baumanii have been reported in the humid climates of Asia and Australia; it is a rare cause of community-acquired infection in the United States. Staphylococcus aureus, streptococcus pneumonia, and Haemophilus influenzae are the most common bacterial coinfections complicating influenza(2). To our knowledge, Acinetobacter Baumanii pneumonia has not been reported as a bacterial coinfection associated with influenza. Our patient, who was never intubated during the hospital stay, presented with flu like symptoms from the community and was found to have multidrug resistant Acinetobacter baumanii in the cultures.Treatment with tigecycline and polymyxin B resulted in complete resolution of the pneumonia.

CONCLUSIONS: Although multidrug resistant Acinetobacter baumanii infection is commonly associated with intubated patients with prolonged hospital stay, it should be in the differential diagnosis in someone who presents with seasonal influenza like symptoms not improving with first line treatment for flu and common bacterial coinfection.

Reference #1: Fournier PE, Richet H. The epidemiology and control of Acinetobacter baumannii in health care facilities. Clin Infect Dis 2006;42:692.

Reference #2: Chertow DS, Memoli MJ. Bacterial coinfection in influenza: a grand rounds review. JAMA 2013;309:275.

DISCLOSURE: The following authors have nothing to disclose: Ishan Malhotra, Hatem Desoky, Chanaka Seneviratne, Yizhak Kupfer, Prarthna Chandar, Mangalore Amith Shenoy, Taek Yoon, Shyam Shankar, Pavan Irukulla, Pavan Gorukanti, Anand Kumar Rai, Amit Agarwal, Karan Wats, Amogh Gajankush

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