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Kotani T, Inazaki T, Kasai H, Rakuman S, Suzuki K, Urushibara T. Pneumonia due to Achromobacter xylosoxidans with a chronic course resembling non-tuberculous mycobacterial infection. Respirol Case Rep 2024; 12:e01287. [PMID: 38314101 PMCID: PMC10831394 DOI: 10.1002/rcr2.1287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/19/2024] [Indexed: 02/06/2024] Open
Abstract
Achromobacter xylosoxidans is a common bacterium that rarely causes pneumonia. Determining whether A. xylosoxidans is the cause of lung infection in patients suspected of having chronic infectious lung disease is challenging because it can present with colonization. We report a case of a 56-year-old immunocompetent woman suspected of having non-tuberculous mycobacteria (NTM) infection on imaging examination and monitored for 3 years. Sputum examinations revealed A. xylosoxidans several times, and it was determined to be a colonization. A. xylosoxidans was isolated from bronchial lavage fluid and aspirated sputum, but no evidence of NTM was observed. She was diagnosed with A. xylosoxidans infection and given ceftazidime for 2 weeks. Her symptoms and imaging findings improved rapidly after treatment, without recurrences. A. xylosoxidans rarely causes chronic lower respiratory tract infections similar to NTM in immunocompetent patients. A. xylosoxidans may be a target for treatment when detected in lower respiratory tract specimens.
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Affiliation(s)
- Tomoko Kotani
- Department of RespirologyKimitsu Chuo HospitalKisarazuJapan
| | | | - Hajime Kasai
- Department of RespirologyKimitsu Chuo HospitalKisarazuJapan
- Department of RespirologyGraduate School of Medicine, Chiba UniversityChibaJapan
- Department of Medical EducationGraduate School of Medicine, Chiba UniversityChibaJapan
- Health Professional Development CenterChiba University HospitalChibaJapan
| | | | - Kenichi Suzuki
- Department of RespirologyKimitsu Chuo HospitalKisarazuJapan
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Shikano K, Ishii D, Umimura T, Rakuman S, Maki S, Kasai H, Orita S, Iwasawa S, Sugiura T, Ohtori S, Tatsumi K. Spondylodiscitis and spinal epidural abscess related to long-term placement of an airway stent for malignant central airway obstruction. Thorac Cancer 2020; 11:2343-2346. [PMID: 32579282 PMCID: PMC7396361 DOI: 10.1111/1759-7714.13530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 12/02/2022] Open
Abstract
A 70‐year‐old male was referred to our hospital with lower limb muscle weakness and numbness of the left hand. The patient had previously been diagnosed seven years ago with lung cancer accompanied by central airway obstruction and had received chemoradiotherapy following placement of a metallic stent. Computed tomography (CT) scan revealed an osteolytic lesion which was adjacent to the fractured stent. T2‐weighted magnetic resonance imaging (MRI) demonstrated high signal intensity in the disc space. The patient was diagnosed with spondylodiscitis and spinal epidural abscess related to the airway stent. Despite hemilaminectomy, laminectomy and long‐term antibiotic therapy, the infection was uncontrolled. Moreover, osteolytic destruction and kyphotic deformity progressed. Removal of the airway stent was necessary; however, it was impossible because bronchial resection was required and the risk of mediastinal injury was considered to be high. The patient subsequently received palliative care. Long‐term airway stenting can cause spondylodiscitis and spinal epidural abscess. Indications for the placement of metallic stents for malignant central airway obstruction should be carefully evaluated after considering the difficulty in removal and the long‐term risk of severe complications. Key points Significant findings of the study Long‐term placement and fracture of the airway stent can cause spondylodiscitis and spinal epidural abscess. What this study adds The indication of placement of a metallic stent for malignant central airway obstruction should be considered with caution, especially if long‐term survival can be expected.
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Affiliation(s)
- Kohei Shikano
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Daisuke Ishii
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tomotaka Umimura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shintaro Rakuman
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Satoshi Maki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hajime Kasai
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Sumihisa Orita
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shunichiro Iwasawa
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Toshihiko Sugiura
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
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