Acinetobacter Pnömonisi Ýliþkili Septik Pulmoner Emboli

Septik pulmoner emboli, birincil enfeksiyon kaynaðýndaki mikroorganizma içeren trombüsün dolaþýma karýþmasý sonucu, pulmoner arterlerde enfarkt ve akciðer parankiminde bilateral multipl nodül ve/veya kaviteye yol açan nadir bir enfektif akciðer hastalýðýdýr. Olgumuz, 58 yaþýnda KOAH alevlenme tanýsýyla yatýrýlmýþ olup, yatýþýnýn 4. gününde ateþ, öksürük, nefes darlýðýnda artýþ, akciðer grafisinde bilateral yaygýn infiltrasyon geliþmesi üzerine yoðun bakýmda invazif mekanik ventilatörde takip edildi. Toraks bilgisayarlý tomografisinde; periferik yerleþimli ve bazýlarý kaviter olan nodüller, infiltrasyon, maximum 1 cm olan mediastinal lenfadenomegali, bilateral plevral effüzyon ve besleyici damar belirtisi izlendi. Geniþ spektrumlu antibiyotik ve antifungal tedaviye yanýt alýnamayan hastanýn exitusundan sonra trakeal aspirat kültüründe Acinetobacter baumannii / calcoaceticus (antibiyogramýndaki antibiyotiklerin tümüne dirençli) üremesi saptandý. Mortalitesi yüksek olan septik pulmoner emboli etyolojisinde gram negatif pnömoni saptanmasý nadir bildirilmiþ olup, bu nedenden dolayý olguyu literatür eþliðinde tartýþmayý amaçladýk.

Septic Pulmonary Embolism Associated with Acinetobacter Pneumonia

Septic pulmonary embolism is an infective lung disease that leads to infarction in the pulmonary arteries and bilateral multiple nodules and/or cavitations in the lung parenchyma resulting from the circulation of thrombus in the bloodstream as infected with microorganisms in the primary infectious focus. A 58-year-old case we have presented was hospitalized with the diagnosis of COPD exacerbation and was taken to the intensive care unit to be monitored in the invasive mechanical ventilator because of fever, cough, increased dyspnea and development of bilateral diffuse infiltration encountered by chest x-ray. Thoracic computed tomography encountered peripherally localized and partly cavitary nodules, infiltration, mediastinal lymphadenomegaly with a maximum diameter of 1 cm, bilateral pleural effusion and feeding vessel sign. After exitus of the patient who was unresponsive to broad spectrum antibiotic and antifungal therapy; tracheal aspirate culture test indicated the growth of Acinetobacter baumannii /calcoaceticus (resistant to all the antibiotics in the antibiogram). The detection of Gram Negative Pneumonia has been rarely reported in the etiology of septic pulmonary embolism that presents a high mortality rate, therefore, we aimed to discuss that case in the light of literature data.

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