Ventilator-associated cavitary pneumonia after lung contusion: a case report

Area of Science:

• Infectious Diseases
• Pulmonology
• Critical Care Medicine

Background:

• Ventilator-associated cavitary pneumonia (VCP) is typically caused by common pathogens like Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa.
• Escherichia coli-associated cavitary pneumonia is rare, predominantly seen in immunocompromised individuals.
• The increasing prevalence of multidrug-resistant organisms necessitates a broader differential diagnosis for VCP.

Purpose of the Study:

• To report a rare case of VCP caused by multidrug-resistant Escherichia coli.
• To emphasize the emerging role of E. coli in VCP etiology.
• To highlight the importance of considering E. coli in the differential diagnosis of VCP.

Main Methods:

• Case report detailing a 27-year-old male patient of Iranian Baluch ethnicity.
• The patient presented with pulmonary contusion and intracranial hemorrhage following trauma.
• Diagnosis of VCP caused by multidrug-resistant E. coli was established.

Main Results:

• The patient developed ventilator-associated cavitary pneumonia.
• The causative agent was identified as multidrug-resistant Escherichia coli.
• This case underscores the potential for E. coli to cause VCP in critically ill patients.

Conclusions:

• Escherichia coli is an emerging pathogen in ventilator-associated pneumonia.
• E. coli should be considered in the differential diagnosis of cavitary pneumonia, particularly in the context of VCP.
• This case expands the understanding of E. coli as a cause of VCP beyond immunocompromised populations.