[A pneumonia case caused by Cedecea lapagei]

Cedecea spp. which are the members of Enterobacteriaceae family, are mostly isolated from sputum and their clinical importance is not yet demonstrated. This report presents a pneumonia case caused by Cedecea lapagei. A 38-years-old male patient admitted to Inonu University Faculty of Medicine Emergency department with prediagnosis of subarachnoid haemorrhage was operated and transferred to Intensive Care Unit of Reanimation where he underwent artificial ventilation. On the third day of hospitalization his temperature was 39 degrees C, white blood cell count was 27.000/ml and he was still unconscious. He had a history of chronic obstructive pulmonary disease. Chest X-ray revealed opacities in the right lower lobe and mucoid tracheal secretion ensued following tracheal entubation performed after operation. Direct microscopic examination of bronchoalveolar lavage (BAL) fluid yielded abundant number of leukocytes and gram-negative bacilli. Bacteria isolated from BAL specimen were identified as C. lapagei by Phoenix 100 (Becton Dickinson, USA) automated system and also by API 20E kit (Biomerieux, France). Upon the initiation of intravenous amikacin (1 x 1 g) and meropenem (3 x 1 g), the signs of infection decreased in intensity, however, the patient was lost due to subarachnoid hemorrhage on the 12th day of hospitalization. In this case it was estimated that C. lapagei pneumonia originated from the aspiration of upper airway secretion owing to unconsciousness of the patient. Although there were reports of Cedecea infections in the literature, this was the first documented case of C. lapagei pneumonia when the accessible related literature was concerned.