A 57-year old man has been in the hospital in New York City on a ventilator for
ID: 127723 • Letter: A
Question
A 57-year old man has been in the hospital in New York City on a ventilator for 3 days when he developed a severe pneumonia characterized by grossly bloody sputum. The doctors immediately started him on cephalosporin, a broad spectrum antibiotic, and send a sputum sample to the lab for identification. The test comes back showing a Gram negative coccobacilli resistant to all of the -lactams, including cephalosporins, fluoroquinolones, aminoglycosides, and the carbapenems. The doctors begin to treat the pneumonia aggressively with a new antibiotic, tigecycline. Fortunately, the patient responds to treatment and begins to improve. What is the most likely cause of the man’s nosocomially acquired pneumonia? What is one other cause of pneumonia?
Explanation / Answer
Nosocomial pneumonia or Hospital-acquired pneumonia (HAP) is generally referred as a patient in a hospital contracted any pneumonia 48–72 hours after admitting. Mostly nosocomially acquired pneumonia was caused by bacterial infection and is most prevalent in surgical intensive care units (ICUs) and medical units.
The most likely cause of Nosocomial pneumonia:
1. Intravenous therapy for wound care within the preceding 30 days.
2. Hemodialysis clinic within the preceding 30 days or outpatient treatment in a hospital.
3. Hospitalization in an acute-care hospital within the preceding 90 days.
4. Residence in a long-term care facility.
One other cause of pneumonia: Pneumonia was mostly caused bacteria and virus. Other causes are less frequently causes this disease.
Ex: An inhaled air borne fungal spores can also cause pneumonia. In the deep of lungs these spores can lodged and trigger an immune response and creates an infection. The fungal pneumonia was most common found among immunocompromised patients.
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