Pulmonary Pneumatocele in a Pneumonia Patient Infected with Extended-Spectrum β-Lactamase Producing Proteus mirabilis

Tuberc Respir Dis (Seoul). 2015 Oct;78(4):371-4. doi: 10.4046/trd.2015.78.4.371. Epub 2015 Oct 1.

Abstract

Pulmonary pneumatoceles are air-filled thin-walled spaces within the lung and are rare in adult cases of pneumonia. We report the case of a 74-year-old male who was admitted with a cough and sputum production. He had been treated with oral dexamethasone since a brain tumorectomy 6 months prior. Contrast-enhanced computed tomography (CT) of the chest revealed a large pneumatocele in the right middle lobe and peripheral pneumonic consolidation. Bronchoalveolar lavage was performed; cultures identified extended-spectrum β-lactamase (ESBL) producing Proteus mirabilis. A 4-week course of intravenous ertapenem was administered, and the pneumatocele with pneumonia resolved on follow-up chest CT. To the best of our knowledge, this is the first reported case of pulmonary pneumatocele caused by ESBL-producing P. mirabilis associated with pneumonia.

Keywords: Beta-Lactamase; Pneumonia; Proteus mirabilis.