Tuberc Respir Dis.  2008 Jan;64(1):33-38. 10.4046/trd.2008.64.1.33.

Two Cases of Pulmonary Infection due to A. xylosoxidans Infection in an Immunocompentent Patient

• Lee JH
• Nam DH
• Kim DH
• Kim SH
• Kim HN
• Han CH
• Lee SM
• Kim CJ

• KMID: 1478139
• DOI: http://doi.org/10.4046/trd.2008.64.1.33

Abstract

lcaligenes xylosoxidans is a catalase and oxidase positive, motile, nonfermentative and gram-negative rod bacterium. A. xylosoxidans infection is a rare cause of pulmonary infection and little information concerning treatment is available. The majority of patients that develop A. xylosoxidans infection belong to a high-risk group due to an immunocompromised condition or due to pulmonary cystic fibrosis. We report two rare cases of immunocompentent patients that developed a pulmonary infection due to A. xylosoxidans. A 77-year-old man was admitted with a lung abscess. The patient denied having any prior medical illness. A culture of bronchial washing fluid showed the presence of A. xylosoxidans. Despite appropriate antibiotic treatment, the patient died from acute respiratory distress syndrome (ARDS). Another patient, a 61-year-old man without an underlying disease, was admitted with empyema. Under the condition of a closed thoracostomy, a high fever persisted and the empyema was also aggravated. A. xylosoxidans was detected from a culture of pleural fluid. Susceptible antibiotic treatment was provided and surgical intervention was performed. We report these cases with a review of the literature.

Keyword

Alcaligenes xylosoxidans; Pulmonary infection; Gram-negative rod

MeSH Terms

Aged
Catalase
Cystic Fibrosis
Empyema
Fever
Humans
Lung Abscess
Middle Aged
Oxidoreductases
Respiratory Distress Syndrome, Adult
Thoracostomy
Catalase
Oxidoreductases

Figure

• 

  Figure 1 Case 1: Initial chest X-ray shows ill-defined mass, probably associated with peripheral collapse or pneumonic consolidation in the area of left upper lobe (A). Following chest x-ray (HOD#14), the lung abscess on the apical area of left upper lobe has decreased but pneumonic consolidation has developed at left lower lobe (B).

• 

  Figure 2 Case 1: Initial chest CT shows necrotic mass and cavity in the left upper lobe (A). Small amount of bilateral pleural effusion and lymphadenitis at right hilar and bilateral mediastinal areas were noted (B). Following chest CT (HOD#20) shows that the size of lung abscess has decreased at the left upper lobe (C).

• 

  Figure 3 Case 2: Initial chest X-ray shows that large amount of loculated hydropneumothorax at the left thorax (A). Following chest X-ray shows that the empyema has been improved (B).

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