A case of round pneumonia due to Enterobacter hormaechei: the need for a standardized diagnosis and treatment approach in adults

• Autor(a) principal: Jiménez-Castillo, Raúl Alberto
• Data de Publicação: 2021
• Outros Autores: Aguilar-Rivera, Leonardo René, Carrizales-Sepúlveda, Edgar Francisco, Gómez-Quiroz, Ricardo Andrés, Llantada-López, Anabella Rosalía, González-Aguirre, Julio Edgardo, Náñez-Terreros, Homero, Rendón-Ramírez, Erick Joel
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista do Instituto de Medicina Tropical de São Paulo
• Texto Completo: https://www.revistas.usp.br/rimtsp/article/view/184017
• topic: Round pneumonia; Adults; Liver cirrhosis; Enterobacter hormaechei

Round pneumonia is an unusual radiological manifestation of a bacterial lung infection. We present the case of an elderly male patient who arrived at the emergency room with a productive cough and exertional dyspnea. His chest x-ray and CT showed a round opacity and air bronchograms in the right upper lobe. Taken together, the patient’s symptoms and images strongly suggest a pulmonary infection. Empirical antibiotic therapy with ceftriaxone and clarithromycin was started. The sputum culture was positive for Enterobacter hormaechei and the bacterium was sensitive to levofloxacin; therefore, the antibiotic therapy was changed. Despite the treatment, the patient progressed to respiratory failure and septic shock, dying six days after admission. Although round pneumonia is uncommon, it is a potentially curable disease and clinicians should always consider it in their differential diagnosis.