A case of Klebsiella pneumoniae pneumonia with a cavitary lesion in the lung with COVID-19 pneumonia

Abstract

Bacterial pneumonia may develop with or following COVID-19 pneumonia in hospitalized patients. It has been reported that mortality rates are high in patients who develop bacterial pneumonia together with COVID-19 pneumonia. In this article, a 63-year-old male patient who was diagnosed with probable COVID-19 pneumonia by thorax computed tomography and then secondary bacterial pneumonia due to Klebsiella pneumoniae (K. pneumoniae) is presented. The patient, whose clinical and laboratory findings improved after COVID-19 pneumonia and appropriate antimicrobial therapy due to K. pneumoniae was discharged. In conclusion, it should be kept in mind that secondary bacterial pneumonia agents may be added to the clinical picture in patients whose clinical and laboratory findings do not improve despite the treatment of COVID-19 pneumonia.

Keywords

• COVID-19
• bacterial pneumonia
• coinfection
• Klebsiella pneumoniae

COVID-19 pnömonisi ile birlikte akciğerde kaviter lezyonla seyreden Klebsiella pneumoniae pnömoni olgusu

Abstract

Hastanede yatan hastalarda COVID-19 pnömonisini ile birlikte veya takiben bakteriyel pnömoni gelişebilir. COVID-19 pnömonisi ile birlikte bakteriyel pnömoni gelişen hastalarda mortalite oranlarının yüksek olduğu bildirilmiştir. Bu yazıda, toraks bilgisayarlı tomografisi ile olası COVID-19 pnömonisi tanısı konulan ve sonrasında Klebsiella pneumoniae (K. pneumoniae) ’ya bağlı sekonder bakteriyel pnömoni 63 yaşında erkek hasta sunuldu. COVID-19 pnömonisi ve K. pneumoniae’ya bağlı uygun antimikrobiyal tedavi sonrasında klinik ve laboratuar bulguları düzelen hasta taburcu edildi. Sonuç olarak, COVID-19 pnömonisi tedavisine rağmen klinik ve laboratuar bulguları düzelmeyen hastalarda klinik tabloya sekonder bakteriyel pnömoni etkenlerinin eklenmiş olabileceği akılda tutulmalıdır.

Keywords

• COVID-19
• bakteriyel pnömoni
• koinfeksiyon
• Klebsiella pneumoniae

References

1. Hughes S, Troise O, Donaldson H, Mughal N, Moore LSP. Bacterial and fungal coinfection among hospitalized patients with COVID-19: a retrospective cohort study in a UK secondary-care setting. Clin Microbiol Infect 2020: 1395-9.
2. Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Inten Care Med 2020; 46: 846-8.
3. Mirzaei R, Goodarzi P, Asadi M, et al. Bacterial co-infections with SARS-CoV-2. IUBMB Life 2020; 72: 2097-111.
4. Lai CC, Wang CY, Hsueh PR. Co-infections among patients with COVID19: The need for combination therapy with non-anti-SARS-CoV-2 agents? J Microbiol Immunol Infect 2020; 53: 505-12.
5. Lai CC, Chen SY, Ko WC, Hsueh PR. Increased antimicrobial resistance during the COVID-19 pandemic. Int J Antimicrob Agents 2021; 57: 106324.
6. Li J, Wang J, Yang Y, Cai P, Cao J, Cai X. Etiology and antimicrobial resistance of secondary bacterial infections in patients hospitalized with COVID-19 in Wuhan, China: a retrospective analysis. Antimicrob Resist Infect Control. 2020; 9: 153.
7. Arcari G, Raponi G, Sacco F, et al. Int J Antimicrob Agents 2021; 57: 106245.
8. Sreenath K, Batra P, Vinayaraj EV, et al. Coinfections with other respiratory pathogens among patients with COVID-19. Microbiol Spectr 2021; 9: e00163-21.

9. Contou D, Claudinon A, Pajot O, et al. Bacterial and viral co-infections in patients with severe SARS-CoV-2 pneumonia admitted to a French ICU. Ann Intensive Care 2020; 10: 119.
10. Song W, Jia X, Zhang X, Ling Y, Yi Z. Co-infection in COVID-19, a cohort study. J Infect 2021; 8: 414–51.
11. Anton-Vazquez V, Clivillé R. Streptococcus pneumoniae co-infection in hospitalised patients with COVID-19. Eur J Clin Microbiol Infect Dis 2021; 40: 1353–5.
12. Mutlu P, Mirici A, Gönlügür U, et al. Evaluating the clinical, radiological, microbiological, biochemical parameters and the treatment response in COVID-19 pneumonia. J Health Sci Med 2022; 5: 544-51.
13. Nata Pratama Hardjo Lugito. Is procalcitonin a part of human immunological response to SARS-CoV-2 infection or “just” a marker of bacterial coinfection? Curr Res Transl Med 2021; 69: 103289.
14. Şenol FF, Bahçeci İ, Arslan N, Aytaç Ö, Öner P, Aşçı Toraman Z. Comparison of respiratory tract pathogens and antibiotic susceptibility profiles of patients diagnosed with COVID-19 with pre-COVID-19. J Health Sci Med 2022; 5: 510-6.