Acinetobacter: A Rare Cause of Rapid Development of Cavitary Lung Lesion Following COVID-19 Infection

Chowdhury, Tutul; Mainali, Arjun; Bellamkonda, Amulya; Gousy, Nicole

doi:10.7759/cureus.24366

Cited by 4 publications

(7 citation statements)

References 10 publications

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“…Although significant differences may be seen on CT scans from COVID-19 patients, typical characteristic radiographic features include multifocal and bilateral ground-glass opacities in a predominantly peripheral distribution [ 1 ]. CT findings of pleural effusion, pericardial effusion, and pulmonary cavitation are uncommon and should prompt further investigation in these patients given the increased rates of morbidity and mortality seen with viral-bacterial coinfections.…”

Section: Discussionmentioning

confidence: 99%

“…Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) involves multiple organ systems, mainly lungs [ 1 ]. Secondary bacterial infections are very common in post-viral infections.…”

Section: Introductionmentioning

confidence: 99%

“…Secondary bacterial infections are very common in post-viral infections. Community-acquired staphylococcal pneumonia is usually seen in patients recovering from influenza with an increased risk seen in patients colonized with Staphylococcus aureus on their skin or the nares [ 1 ]. Active viral infections compromise local immunity within the respiratory tissues predisposing to the development of superinfection/coinfection causing necrotizing pneumonia leading to lung cavities [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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COVID-19 and Cavitary Lesion in Lung

Vangara¹,

Rahmlow²,

Gullapalli³

et al. 2023

Cureus

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The clinical manifestations of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are widespread, ranging from asymptomatic to critical illness with significant morbidity and mortality. It is widely known that individuals who have viral respiratory infections are more likely to develop bacterial infections. Throughout the pandemic, despite the fact that COVID-19 was thought to be the primary cause of millions of deaths, bacterial coinfections, superinfections, and other secondary complications played a significant role in the increased mortality rate. In our case, a 76-year-old male presented to the hospital complaining of shortness of air. Polymerase chain reaction (PCR) testing was positive for COVID-19 and cavitary lesions were discovered on imaging. Treatment was guided based on the results of bronchoscopy with bronchoalveolar lavage (BAL) cultures showing methicillin-resistant Staphylococcus aureus (MRSA) and Mycobacterium gordonae. However, the case was later complicated by the development of a pulmonary embolism after anticoagulants were held due to new onset hemoptysis. Our case highlights the importance of considering bacterial coinfection in cavitary lung lesions, appropriate antimicrobial stewardship, and close follow-up for full recovery in COVID-19 infections.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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COVID-19 and Cavitary Lesion in Lung

Vangara¹,

Rahmlow²,

Gullapalli³

et al. 2023

Cureus

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“…Several trials highlighted the importance of MDR Acinetobacter pneumonia (AP), reporting mortality rates near to 90%, especially in patients who required mechanical ventilation [10]. Typically, these bacteria will cause VAP, especially in critically ill patients; recent studies have shown that approximately 1-28% of COVID-19 patients with the active disease on ventilators will subsequently develop a superimposed Ab infection while on the ventilator [11]. Furthermore, Carbapenem-resistant Ab infections in COVID-19-positive patients admitted to the ICU were more frequent compared to those that were COVID-19 negative [12].…”

Section: Introductionmentioning

confidence: 99%

“…To the best of our knowledge, in the literature, there have been reported some case report and series, but there is no previous report which focuses on the imaging findings of AP [11,[18][19][20]. The aim of this retrospective study was to describe the imaging features on CXRs and CT scans in hospitalized patients with MDR AP, which can help to suspect an infection.…”

Section: Introductionmentioning

confidence: 99%

Alert Germ Infections: Chest X-ray and CT Findings in Hospitalized Patients Affected by Multidrug-Resistant Acinetobacter baumannii Pneumonia

Capasso

Pinto

Serra³

et al. 2022

Tomography

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Acinetobacter baumannii (Ab) is an opportunistic Gram-negative pathogen intrinsically resistant to many antimicrobials. The aim of this retrospective study was to describe the imaging features on chest X-ray (CXR) and computed tomography (CT) scans in hospitalized patients with multidrug-resistant (MDR) Ab pneumonia. CXR and CT findings were graded on a three-point scale: 1 represents normal attenuation, 2 represents ground-glass attenuation, and 3 represents consolidation. For each lung zone, with a total of six lung zones in each patient, the extent of disease was graded using a five-point scale: 0, no involvement; 1, involving 25% of the zone; 2, 25–50%; 3, 50–75%; and 4, involving >75% of the zone. Points from all zones were added for a final total cumulative score ranging from 0 to 72. Among 94 patients who tested positive for MDR Ab and underwent CXR (males 52.9%, females 47.1%; mean age 64.2 years; range 1–90 years), 68 patients underwent both CXR and chest CT examinations. The percentage of patients with a positive CT score was significantly higher than that obtained on CXR (67.65% > 35.94%, p-value = 0.00258). CT score (21.88 ± 15.77) was significantly (p-value = 0.0014) higher than CXR score (15.06 ± 18.29). CXR and CT revealed prevalent bilateral abnormal findings mainly located in the inferior and middle zones of the lungs. They primarily consisted of peripheral ground-glass opacities and consolidations which predominated on CXR and CT, respectively.

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Pulmonary Cavitation as a Complication of COVID-19: Case Series and a Brief Review of the Literature

Aghamohammadi,

Ghodrati,

Etemadi Sh

et al. 2024

AMH

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The COVID-19 pandemic has led to an unprecedented surge in respiratory illness cases worldwide. Although uncommon, pulmonary cavitation has been reported as a potential complication of COVID-19. This case series report describes four cases of COVID-19 patients with lung cavities, highlighting the various causes and clinical manifestations of this complication, and a review of the literature on the presence of lung cavities in COVID-19 patients. In two cases, the cavities were most likely due to secondary bacterial superinfections, with one case being complicated by multi-drug-resistant bacteria. Another case developed cavities secondary to a fungal infection, while the third case was directly caused by SARS-CoV-2 invasion in the lungs. The presence of cavities with or without air-fluid level or pneumothorax in COVID-19 patients should be considered as a potential complication of this infection, especially in those with respiratory symptoms. Physicians should remain vigilant for the development of pulmonary cavitation in COVID-19 patients, particularly those receiving high doses of steroids. Additionally, spontaneous pneumothorax should be considered an alarming sign in COVID-19 patients.

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Acinetobacter: A Rare Cause of Rapid Development of Cavitary Lung Lesion Following COVID-19 Infection

Cited by 4 publications

References 10 publications

COVID-19 and Cavitary Lesion in Lung

COVID-19 and Cavitary Lesion in Lung

Alert Germ Infections: Chest X-ray and CT Findings in Hospitalized Patients Affected by Multidrug-Resistant Acinetobacter baumannii Pneumonia

Pulmonary Cavitation as a Complication of COVID-19: Case Series and a Brief Review of the Literature

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