Lung adenocarcinoma masquerading as refractory Klebsiella pneumoniae.
We report the case of a middle-aged man where a diagnosis of Klebsiella pneumoniae obscured the underlying malignancy. The patient was hospitalised for management of a presumed refractory community-acquired pneumonia with radiological features of right lower lobe consolidation. Bronchoscopy did not identify an endobronchial lesion and washings grew K pneumoniae. CT-guided fine-needle aspirate samples did not detect any malignancy. However, despite appropriate antibiotic treatment there was no improvement in the patient's clinical condition. Consequently, a CT-guided lung core biopsy was performed to obtain more tissue for histopathology, which was diagnostic of primary lung adenocarcinoma. This case highlights the need to continue to investigate a patient who is not progressing as clinically appropriate to their original diagnosis.
Department of Respiratory Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia.
Clair
C
McCartney
Afshin
A
Moghadam
Krishna B
KB
Sriram
D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis*; D000077192:Adenocarcinoma of Lung; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy; D006801:Humans; D007711:Klebsiella pneumoniae; D008168:Lung / Q000382:microbiology / Q000473:pathology*; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology
D000900:Anti-Bacterial Agents