Plesiomonas shigelloides pneumonia.
Plesiomonas shigelloides is known to cause mild to cholera-like diarrhea in most infected persons. In immunocompromised patients extra-intestinal manifestations have been described. We report the first case of pneumonia caused by P. shigelloides in a 76-year-old woman who had undergone a curative gastrectomy and esophageal-jejunostomy due to a low differentiated adenocarcinoma of the stomach (pT2, pN1 pMx, G3, R0, Lauren: intestinal type). The patient was admitted in hospital with clinical signs of pulmonary infection. CT-scan revealed a cavernous lesion in the right upper pulmonary lobe. Bronchial lavage showed a granulocytic inflammation 105CFU/ml P. shigelloides. Although antibiotic treatment led to a decrease of inflammation parameters and decrease of the pulmonary infiltrate the patient died due to development of torsades de pointes tachycardia leading to ventricular fibrillation and hypoxic brain damage.
Schneider
F
F
Department of Internal Medicine III, Ludwig-Maximilians University, Campus Grosshadern, Marchioninistrasse 15, 81377 München, Germany. Friederike.Schneider@med.uni-muenchen.de
Lang
N
N
Reibke
R
R
Michaely
H J
HJ
Hiddemann
W
W
Ostermann
H
H
D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D016905:Gram-Negative Bacterial Infections / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007249:Inflammation / Q000382:microbiology; D007582:Jejunostomy / Q000009:adverse effects*; D016981:Plesiomonas; D011859:Radiography; D013274:Stomach Neoplasms / Q000601:surgery*; D013610:Tachycardia / Q000209:etiology; D016171:Torsades de Pointes / Q000209:etiology; D014474:Unconsciousness / Q000209:etiology; D014693:Ventricular Fibrillation / Q000209:etiology