Work

Community-acquired Acinetobacter pneumonia associated with Evans syndrome: a case report

Year: 2025

Type: article

Abstract: BackgroundAcinetobacter baumannii is a gram-negative bacterium and a rare cause of community-acquired pneumonia (CAP). CAP caused by A. baumannii primarily manifests as fever, productive cough, and shortness of breath, and is associated with high morbidity and mortality due to its resistance to multiple antibiotics. Evans syndrome (ES) is a rare autoimmune disorder characterized by immune thrombocytopenic purpura (ITP) and autoimmune hemolytic anemia (AIHA). The coexistence of CAP due to A. baumannii and Evans syndrome is rarely documented.Case presentationA 19-year-old male with a one-year history of Evans syndrome presented with acute onset of fever, shortness of breath, and productive cough. Initial clinical evaluation revealed tachycardia, hypotension, and significant pallor. Laboratory findings showed hemolytic anemia, a positive direct Coombs test, severe thrombocytopenia, and macrocytic anemia. Sputum culture identified A. baumannii as resistant to multiple antibiotics but sensitive to polymyxin. Imaging studies showed bilateral lung infiltrates and areas of consolidation, confirming the diagnosis of CAP caused by A. baumannii in the context of exacerbated Evans syndrome. The patient was treated with high-dose corticosteroids for ES and polymyxin for A. baumannii, leading to gradual improvement in symptoms.ConclusionsThis case highlights the rare occurrence of community-acquired A. baumannii pneumonia in a patient with Evans syndrome, emphasizing the importance of considering opportunistic infections in immunocompromised individuals. Timely intervention with appropriate antibiotics and immunosuppressive therapy was crucial in managing this complex case. Multidisciplinary care is essential in similar cases for effective treatment and improved patient outcomes.

Source: Annals of Medicine and Surgery

DOI: 10.1097/ms9.0000000000004168

Authors: Sana Rasheed, Huda Adnan, Rida Arif, Simran Bai, Amidu Alhassan, Abdul Haseeb

Institutions: Jinnah Sindh Medical University, Jinnah Postgraduate Medical Center, University of Cape Coast, All Nations University

Language: English

Topic: Antibiotic Resistance in Bacteria

Subfield: Molecular Medicine

Field: Biochemistry, Genetics and Molecular Biology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,850