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已发表论文
由高毒力铜绿假单胞菌引起的严重社区获得性肺炎伴播散性感染：一例成功治疗的病例
Authors Teng P, Peng J, Zhang X , Wang Y, Jiang C, Wang S, Wang M, Han X , Liu X
Received 14 May 2025
Accepted for publication 11 September 2025
Published 17 September 2025 Volume 2025:18 Pages 12817—12824
DOI https://doi.org/10.2147/JIR.S540213
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Ning Quan
Peikun Teng,1 Jinglan Peng,1 Xingyu Zhang,2 Yujie Wang,3 Chen Jiang,4 Shengyao Wang,1 Mingyu Wang,1,5 Xiudi Han,1 Xuedong Liu1
1Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao, 266000, People’s Republic of China; 2Human Resources Department, Qingdao Municipal Hospital, Qingdao, 266000, People’s Republic of China; 3Microbiology Laboratory, Qingdao Municipal Hospital, Qingdao, 266000, People’s Republic of China; 4Pathology Department, Qingdao Municipal Hospital, Qingdao, 266000, People’s Republic of China; 5State Key Laboratory of Microbial Technology, Microbial Technology Institute, Shandong University, Qingdao, 266237, People’s Republic of China
Correspondence: Xuedong Liu, Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao, 266000, People’s Republic of China, Tel +86 18661678256, Email xuedongliu@263.net Xiudi Han, Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao, 266000, People’s Republic of China, Tel +86 15315002781, Email hanxiudi@163.com
Purpose: Pseudomonas aeruginosa (P. aeruginosa) is a Gram-negative pathogen with strong colonization ability and multidrug resistance. Disseminated infection complicated by secondary organizing pneumonia is extremely uncommon.
Patients and Methods: We describe a rare case of severe community-acquired pneumonia due to highly virulent P. aeruginosa, complicated by endophthalmitis, ecthyma gangrenosum, and secondary organizing pneumonia. Clinical features, microbiological results, histopathology, and treatment were analyzed.
Results: A 61-year-old woman developed a disseminated infection caused by highly virulent P. aeruginosa, presenting with persistent high fever, impaired consciousness, ocular involvement, mucocutaneous erosions, and widespread erythematous papules. The diagnosis was confirmed by consistent isolation of P. aeruginosa from sputum, blood, and ocular pus, and detection in bronchoalveolar lavage fluid by metagenomic sequencing. Whole-genome sequencing of the ocular isolate identified multiple virulence factors, including Type III secretion system effectors ExoS, ExoT, and ExoY, reflecting the pathogen’s capacity for systemic dissemination. Lung biopsy revealed extensive necrosis with fibrinoid exudation and granulation tissue, consistent with secondary organizing pneumonia. The patient received combined antimicrobial and anti-inflammatory therapy targeting both the disseminated infection and the organizing pneumonia, resulting in rapid defervescence, restoration of consciousness and oral intake, and clinical improvement. She was subsequently discharged in stable condition.
Conclusion: This case highlights the disseminated potential of highly virulent P. aeruginosa and underscores the need for vigilance regarding secondary organizing pneumonia in such infections. Timely recognition, together with a treatment strategy combining appropriate antimicrobial and anti-inflammatory therapy, is crucial to improving patient outcomes.
Keywords: systemic disseminated infection, highly virulent Pseudomonas aeruginosa, secondary organizing pneumonia
1Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao, 266000, People’s Republic of China; 2Human Resources Department, Qingdao Municipal Hospital, Qingdao, 266000, People’s Republic of China; 3Microbiology Laboratory, Qingdao Municipal Hospital, Qingdao, 266000, People’s Republic of China; 4Pathology Department, Qingdao Municipal Hospital, Qingdao, 266000, People’s Republic of China; 5State Key Laboratory of Microbial Technology, Microbial Technology Institute, Shandong University, Qingdao, 266237, People’s Republic of China
Correspondence: Xuedong Liu, Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao, 266000, People’s Republic of China, Tel +86 18661678256, Email xuedongliu@263.net Xiudi Han, Department of Respiratory and Critical Care Medicine, Qingdao Municipal Hospital, Qingdao, 266000, People’s Republic of China, Tel +86 15315002781, Email hanxiudi@163.com
Purpose: Pseudomonas aeruginosa (P. aeruginosa) is a Gram-negative pathogen with strong colonization ability and multidrug resistance. Disseminated infection complicated by secondary organizing pneumonia is extremely uncommon.
Patients and Methods: We describe a rare case of severe community-acquired pneumonia due to highly virulent P. aeruginosa, complicated by endophthalmitis, ecthyma gangrenosum, and secondary organizing pneumonia. Clinical features, microbiological results, histopathology, and treatment were analyzed.
Results: A 61-year-old woman developed a disseminated infection caused by highly virulent P. aeruginosa, presenting with persistent high fever, impaired consciousness, ocular involvement, mucocutaneous erosions, and widespread erythematous papules. The diagnosis was confirmed by consistent isolation of P. aeruginosa from sputum, blood, and ocular pus, and detection in bronchoalveolar lavage fluid by metagenomic sequencing. Whole-genome sequencing of the ocular isolate identified multiple virulence factors, including Type III secretion system effectors ExoS, ExoT, and ExoY, reflecting the pathogen’s capacity for systemic dissemination. Lung biopsy revealed extensive necrosis with fibrinoid exudation and granulation tissue, consistent with secondary organizing pneumonia. The patient received combined antimicrobial and anti-inflammatory therapy targeting both the disseminated infection and the organizing pneumonia, resulting in rapid defervescence, restoration of consciousness and oral intake, and clinical improvement. She was subsequently discharged in stable condition.
Conclusion: This case highlights the disseminated potential of highly virulent P. aeruginosa and underscores the need for vigilance regarding secondary organizing pneumonia in such infections. Timely recognition, together with a treatment strategy combining appropriate antimicrobial and anti-inflammatory therapy, is crucial to improving patient outcomes.
Keywords: systemic disseminated infection, highly virulent Pseudomonas aeruginosa, secondary organizing pneumonia