title: Persistence of Pseudomonas aeruginosa in a pulmonary nodule with late relapse.
abstract: Lung nodules are common diagnostic challenges in hematopoietic stem cell transplantation and solid organ transplantation. Pseudomonas aeruginosa is a known cause of lung abscess in these patients, but its ability to persist for months in a quiescent lung nodule and later cause recurrent infection is not well known or documented. A patient with a history of acute pre-B-cell lymphoblastic leukemia had enlargement and cavitation of a small right upper lobe pulmonary nodule 10 months after allogeneic hematopoietic stem cell transplantation. The nodule was the remnant of a presumed P. aeruginosa septic embolus that occurred 2.5 months after transplantation. With antibiotic treatment, the nodule had shrunk in size to <1 cm and remained stable. Transthoracic needle aspiration grew P. aeruginosa indistinguishable by molecular typing from isolates obtained 7.5 months earlier from blood and bronchoalveolar lavage fluid. Sub-centimeter pulmonary nodules attributable to previously treated P. aeruginosa may harbor viable organisms and lead to recrudescent infection.
authors: Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
authors: S
authors: S
authors: Ronkainen
authors: Y
authors: Y
authors: Xie
authors: M
authors: M
authors: Battiwalla
authors: A J
authors: AJ
authors: Barrett
authors: F
authors: F
authors: Stock
authors: J P
authors: JP
authors: Dekker
authors: R L
authors: RL
authors: Danner
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008169:Lung Abscess / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D012008:Recurrence; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents
keywords: Pseudomonas aeruginosa; hematopoietic stem cell transplant; lung abscess; recrudescent infection; septic pulmonary embolus