title: Pulmonary Gangrene Due to Rhizopus spp., Staphylococcus aureus, Klebsiella pneumoniae and Probable Sarcina Organisms.
abstract: Pulmonary gangrene is a life-threatening condition, which represents the fulminant end of the infectious lung diseases usually caused by polymicrobial infection. Aerobic and anaerobic bacteria act synergistically to produce massive tissue necrosis which might be augmented by the angioinvasive nature of fungi like Mucor. We report a successfully treated case of pulmonary gangrene in a poorly controlled diabetic patient, which was associated with polymicrobial infection. It was caused by Rhizopus spp., Staphylococcus aureus, Klebsiella pneumoniae and unusual anaerobic organism Sarcina. This is the first report describing the presence of Sarcina organisms in a case of pulmonary gangrene. Adequate glycemic control, treatment of coexisting polymicrobial infection and prompt antifungal therapy along with surgical intervention were useful in the index patient. This case also highlights the effectiveness of combined medical and surgical intervention in a case of pulmonary gangrene.
authors.affiliation: Department of Histopathology, Post Graduate Institute of Medical Education & Research, (PGIMER), Sector - 12, Chandigarh, 160012, India.
authors.forename: Abhijit
authors.initials: A
authors.lastname: Chougule
authors.forename: Valliappan
authors.initials: V
authors.lastname: Muthu
authors.forename: Amanjit
authors.initials: A
authors.lastname: Bal
authors.forename: Shivaprakash M
authors.initials: SM
authors.lastname: Rudramurthy
authors.forename: Sahajal
authors.initials: S
authors.lastname: Dhooria
authors.forename: Ashim
authors.initials: A
authors.lastname: Das
authors.forename: Harkant
authors.initials: H
authors.lastname: Singh
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D060085:Coinfection / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D003646:Debridement; D048909:Diabetes Complications; D005734:Gangrene / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D006651:Histocytochemistry; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D008168:Lung / Q000473:pathology; D008171:Lung Diseases / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D008297:Male; D008853:Microscopy; D013902:Radiography, Thoracic; D012233:Rhizopus / Q000302:isolation & purification; D012505:Sarcina / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000302:isolation & purification; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D007004:Hypoglycemic Agents