https://doi.org/10.4081/amsa.2023.10 Acinetobacter cavitations in COVID-19 interstitial pneumonia: a case report and review of the literature
Submitted: 3 March 2023
Accepted: 10 March 2023
Published: 6 April 2023
Accepted: 10 March 2023
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Acinetobacter baumannii is commonly known to cause infection in immunocompromised patients. During COVID-19 pandemic, outbreaks of multidrug-resistant organisms, including Acinetobacter, have been well documented in acute care hospitals, particularly among critically ill patients. In the case reported, a woman was admitted to our ICU because of a severe COVID-19 pneumonia. During her stay, she worsened due to Acinetobacterrelated lung cavitations and only after proper antibiotic treatment she eventually recovered. To our knowledge, very few cases have been reported pointing to Acinetobacter as a causal agent for the acute development of lung cavities, especially in COVID-19 patients.
Wong D, Nielsen TB, Bonomo RA, et al. Clinical and pathophysiological overview of Acinetobacter infections: A century of challenges. Clin Microbiol Rev 2017;30:409–47. DOI: https://doi.org/10.1128/CMR.00058-16
Boral J, Genç Z, Pınarlık F, et al. The association between Acinetobacter baumannii infections and the COVID-19 pandemic in an intensive care unit. Sci Rep 2022;12:1–7. DOI: https://doi.org/10.1038/s41598-022-25493-8
Eckardt P, Canavan K, Guran R, et al. Containment of a carbapenem-resistant Acinetobacter baumannii complex outbreak in a COVID-19 intensive care unit. Am J Infect Control 2022;50:477–81. DOI: https://doi.org/10.1016/j.ajic.2022.02.022
Perez S, Innes GK, Walters MS, et al. Increase in Hospital-Acquired Carbapenem-Resistant Acinetobacter baumannii Infection and Colonization in an Acute Care Hospital During a Surge in COVID-19 Admissions — New Jersey, February–July 2020. Morbidity and Mortality Weekly Report/Centers for Disease Control and Prevention. 2020;69. DOI: https://doi.org/10.15585/mmwr.mm6948e1
Thoma R, Seneghini M, Seiffert SN, et al. The challenge of preventing and containing outbreaks of multidrug-resistant organisms and Candida auris during the coronavirus disease 2019 pandemic: report of a carbapenem-resistant Acinetobacter baumannii outbreak and a systematic review of the literatu. Antimicrob Resist Infect Control 2022;11:12. DOI: https://doi.org/10.1186/s13756-022-01052-8
Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: Emergence of a successful pathogen. Clin Microbiol Rev 2008;21:538–82. DOI: https://doi.org/10.1128/CMR.00058-07
Carvalheira A, Silva J, Teixeira P. Acinetobacter spp. in food and drinking water – A review. Food Microbiol 2021;95. DOI: https://doi.org/10.1016/j.fm.2020.103675
Nasr P. Genetics, epidemiology, and clinical manifestations of multidrug-resistant Acinetobacter baumannii. J Hosp Infect 2020;104:4–11. DOI: https://doi.org/10.1016/j.jhin.2019.09.021
Fournier PE, Richet H. The epidemiology and control of Acinetobacter baumannii in health care facilities. Clin Infect Dis 2006;42:692–9. DOI: https://doi.org/10.1086/500202
Lin M-F. Antimicrobial resistance in Acinetobacter baumannii: From bench to bedside. World J Clin Cases 2014;2:787. DOI: https://doi.org/10.12998/wjcc.v2.i12.787
Lee CR, Lee JH, Park M, et al. Biology of Acinetobacter baumannii: Pathogenesis, antibiotic resistance mechanisms, and prospective treatment options. Front Cell Infect Microbiol 2017;7:55. DOI: https://doi.org/10.3389/fcimb.2017.00055
Antunes LCS, Visca P, Towner KJ. Acinetobacter baumannii: Evolution of a global pathogen. Pathog Dis 2014;71:292–301. DOI: https://doi.org/10.1111/2049-632X.12125
Rice LB. Federal funding for the study of antimicrobial resistance in nosocomial pathogens: No ESKAPE. J Infect Dis 2008;197:1079–81. DOI: https://doi.org/10.1086/533452
Boucher HW, Talbot GH, Bradley JS, et al. Bad bugs, no drugs: No ESKAPE! An update from the Infectious Diseases Society of America. Clin Infect Dis 2009;48:1–12. DOI: https://doi.org/10.1086/595011
Dijkshoorn L, Nemec A, Seifert H. An increasing threat in hospitals: Multidrug-resistant Acinetobacter baumannii. Nat Rev Microbiol 2007;5:939–51. DOI: https://doi.org/10.1038/nrmicro1789
Garnacho-Montero J, Ortiz-Leyba C, Fernández-Hinojosa E, et al. Acinetobacter baumannii ventilator-associated pneumonia: Epidemiological and clinical findings. Intensive Care Med 2005;31:649–55. DOI: https://doi.org/10.1007/s00134-005-2598-0
Nowak J, Zander E, Stefanik D, et al. High incidence of pandrug-resistant Acinetobacter baumannii isolates collected from patients with ventilator-associated pneumonia in Greece, Italy and Spain as part of the MagicBullet clinical trial. J Antimicrob Chemother 2017;72:3277–82. DOI: https://doi.org/10.1093/jac/dkx322
Karakonstantis S, Kritsotakis EI, Gikas A. Pandrug-resistant gram-negative bacteria: A systematic review of current epidemiology, prognosis and treatment options. J Antimicrob Chemother 2020;75:271–82. DOI: https://doi.org/10.1093/jac/dkz401
Inchai J, Pothirat C, Bumroongkit C, et al. Prognostic factors associated with mortality of drug-resistant Acinetobacter baumannii ventilator-associated pneumonia. J Intensive Care 2015;3:9. DOI: https://doi.org/10.1186/s40560-015-0077-4
Bassetti M, Taramasso L, Giacobbe DR, Pelosi P. Management of ventilator-associated pneumonia: Epidemiology, diagnosis and antimicrobial therapy. Expert Rev Anti Infect Ther 2012;10:585–96. DOI: https://doi.org/10.1586/eri.12.36
Hunt JP, Buechter KJ, Fakhry SM. Acinetobacter calcoaceticus pneumonia and the formation of pneumatoceles. J Trauma - Inj Infect Crit Care 2000;48:964–70. DOI: https://doi.org/10.1097/00005373-200005000-00027
Markelić I, Jakopović M, Klepetko W, et al. Lung abscess: an early complication of lung transplantation in a patient with cystic fibrosis. Int J organ Transplant Med 2017;8:213–6.
Cheng YF, Hsieh YK, Wang BY, et al. Tricuspid valve infective endocarditis complicated with multiple lung abscesses and thoracic empyema as different pathogens: A case report. J Cardiothorac Surg 2019;14:41. DOI: https://doi.org/10.1186/s13019-019-0867-1
Widysanto A, Liem M, Puspita KD, Pradhana CML. Management of necrotizing pneumonia with bronchopleural fistula caused by multidrug-resistant Acinetobacter baumannii. Respirol Case Reports 2020;8:e00662. DOI: https://doi.org/10.1002/rcr2.662
Wade P, Ananthan A, David J, Ghildiyal R. A case of acinetobacter septic pulmonary embolism in an infant. Case Rep Infect Dis 2016;2016:5241571. DOI: https://doi.org/10.1155/2016/5241571
Kokkonouzis I, Christou I, Athanasopoulos I, et al. Multiple lung abscesses due to acinetobacter infection: a case report. Cases J 2009;2:9347. DOI: https://doi.org/10.1186/1757-1626-2-9347
Yang CH, Chen KJ, Wang CK. Community-acquired Acinetobacter pneumonia: A case report. J Infect 1997;35:316–8. DOI: https://doi.org/10.1016/S0163-4453(97)93574-X
Larcher R, Pantel A, Arnaud E, et al. First report of cavitary pneumonia due to community-acquired Acinetobacter pittii, study of virulence and overview of pathogenesis and treatment. BMC Infect Dis 2017;17:477. DOI: https://doi.org/10.1186/s12879-017-2589-0
Kaufman AE, Naidu S, Ramachandran S, et al. Review of radiographic findings in COVID-19. World J Radiol 2020;12:142–55. DOI: https://doi.org/10.4329/wjr.v12.i8.142
Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19): A systematic review of imaging findings in 919 patients. Am J Roentgenol 2020;215:87–93. DOI: https://doi.org/10.2214/AJR.20.23034
Xu Z, Pan A, Zhou H. Rare CT feature in a COVID-19 patient: cavitation. Diagnostic Interv Radiol 2020;26:380–1. DOI: https://doi.org/10.5152/dir.2020.20181
Afrazi A, Garcia-Rodriguez S, Maloney JD, Morgan CT. Cavitary lung lesions and pneumothorax in a healthy patient with active Coronavirus-19 (COVID-19) viral pneumonia. Interact Cardiovasc Thorac Surg 2021;32:150–2. DOI: https://doi.org/10.1093/icvts/ivaa238
Zoumot Z, Bonilla MF, Wahla AS, et al. Pulmonary cavitation: an under-recognized late complication of severe COVID-19 lung disease. BMC Pulm Med 2021;21:24. DOI: https://doi.org/10.1186/s12890-020-01379-1
Muheim M, Weber FJ, Muggensturm P, Seiler E. An unusual course of disease in two patients with COVID-19: pulmonary cavitation. BMJ Case Rep 2020;13:e237967. DOI: https://doi.org/10.1136/bcr-2020-237967
Zamani N, Aloosh O. Lung abscess as a complication of COVID-19 infection, a case report. Clin Case Reports 2021;9:1130–4. DOI: https://doi.org/10.1002/ccr3.3686
Renaud-Picard B, Gallais F, Riou M, et al. Delayed pulmonary abscess following COVID-19 pneumonia: A case report. Respir Med Res 2020;78:100776. DOI: https://doi.org/10.1016/j.resmer.2020.100776
Marchiori E, Nobre LF, Hochhegger B, Zanetti G. Pulmonary infarctions as the cause of bilateral cavitations in a patient with COVID-19. Diagnostic Interv Radiol 2020;27:690–1. DOI: https://doi.org/10.5152/dir.2020.20865
Selvaraj V, Dapaah-Afriyie K. Lung cavitation due to COVID-19 pneumonia. BMJ Case Rep 2020;13:e237245. DOI: https://doi.org/10.1136/bcr-2020-237245
Ammar A, Drapé JL, Revel MP. Lung cavitation in COVID-19 pneumonia. Diagn Interv Imaging 2021;102:117–8. DOI: https://doi.org/10.1016/j.diii.2020.09.007
Amaral LTW, Beraldo GL, Brito VM, et al. Lung cavitation in COVID-19: co-infection complication or rare evolution? Einstein (São Paulo) 2020;18:eAI5822. DOI: https://doi.org/10.31744/einstein_journal/2020AI5822
Peeters K, Mesotten D, Willaert X, et al. Salvage lobectomy to treat necrotizing SARS-CoV-2 pneumonia complicated by a bronchopleural fistula. Ann Thorac Surg 2021;111:e241–3. DOI: https://doi.org/10.1016/j.athoracsur.2020.10.038
Yousaf Z, Khan AA, Chaudhary HA, et al. Cavitary pulmonary tuberculosis with COVID-19 coinfection. IDCases 2020;22:e00973. DOI: https://doi.org/10.1016/j.idcr.2020.e00973
Mishra A, George AA, Sahu KK, et al. Tuberculosis and COVID-19 co-infection: an updated review. Acta Biomed 2020;92:e2021025.
Rachina S, Kiyakbaev G, Antonova E, et al. A clinical case of nosocomial pneumonia as a complication of COVID-19: how to balance benefits and risks of immunosuppressive therapy? Antibiotics 2023;12. DOI: https://doi.org/10.3390/antibiotics12010053
Chowdhury T, Mainali A, Bellamkonda A, Gousy N. Acinetobacter: a rare cause of rapid development of cavitary lung lesion following COVID-19 infection. Cureus 2022;14. DOI: https://doi.org/10.7759/cureus.24366
Brahmbhatt N, Tamimi O, Ellison H, et al. Pneumatocele and cysts in a patient with severe acute respiratory syndrome coronavirus 2 infection. J Thorac Cardiovasc Surg Tech 2020;4:353–5. DOI: https://doi.org/10.1016/j.xjtc.2020.08.047
Sanivarapu RR, Farraj K, Sayedy N, Anjum F. Rapidly developing large pneumatocele and spontaneous pneumothorax in SARS-CoV-2 infection. Respir Med Case Reports 2020;31:101303. DOI: https://doi.org/10.1016/j.rmcr.2020.101303
Capleton P, Ricketts W, Lau K, et al. Pneumothorax and pneumatocoele formation in a patient with COVID-19: a case report. SN Compr Clin Med 2021;1–4. DOI: https://doi.org/10.1007/s42399-020-00689-z
Hamad AM. Post COVID-19 large pneumatocele: clinical and pathological perspectives. Interact Cardiovasc Thorac Surg 2021;1–3. DOI: https://doi.org/10.1093/icvts/ivab072
Castiglioni M, Pelosi G, Meroni A, et al. Surgical resections of superinfected pneumatoceles in a COVID-19 patient. Ann Thorac Surg 2021;111:e23-5. DOI: https://doi.org/10.1016/j.athoracsur.2020.06.008
How to Cite
Di Bari, S., Raumer, L., Circelli, A., Viola, L., Gardelli, G., Bisulli, M., Cristini, F., & Russo, E. (2023). Acinetobacter cavitations in COVID-19 interstitial pneumonia: a case report and review of the literature. Acute Care Medicine Surgery and Anesthesia, 1(1). https://doi.org/10.4081/amsa.2023.10
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