Pseudomonas aeruginosa community-acquired pneumonia following soil ingestion: A case report

Pseudomonas aeruginosa (P. aeruginosa) is an uncommon etiological agent in community-acquired pneumonia (CAP), typically associated with nosocomial or healthcare-associated infections, particularly in patients with underlying structural lung abnormalities or immunosuppression. P. aeruginosa is a ubiquitous gram-negative rod, widely distributed in the environment. However, CAP due to P. aeruginosa following soil ingestion is exceedingly rare.

We present the case of a previously healthy 31-year-old patient, a middle school teacher, who developed CAP due to P. aeruginosa after ingesting garden soil for three consecutive days. The patient was admitted with symptoms including fever, chest pain, vomiting, and diarrhea. Chest computed tomography (CT) revealed two suspicious lesions in the left lower lobe, with one lesion exhibiting cavitation. Microbiological culture of bronchoalveolar lavage fluid (BALF) and stool confirmed the presence of P. aeruginosa infection. Subsequent antimicrobial susceptibility testing revealed that the P. aeruginosa isolate was pan-sensitive. Following 13 days of targeted antimicrobial therapy, the patient's symptoms and laboratory markers of infection improved significantly. A follow-up CT scan one month later demonstrated substantial resolution of the left lower lobe lesions, and the patient remained asymptomatic.

This case, along with a review of related literature, suggests that geophagy may be a potential risk factor for P. aeruginosa infection. It underscores the importance of avoiding the consumption of unprocessed soil, which may be contaminated with pathogenic organisms.