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Lung-nontumor

Infections

Pseudomonas aeruginosa

Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 21 September 2011, last major update September 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Clinical features
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● Aerobic, mobile, flagellated gram negative bacillus that survives in water, soil and vegetation
● Worldwide distribution (eMedicine)
● Resistant to many disinfectants, common in hospital environment, common cause of hospital acquired infections
● Commonly colonizes humans, but rarely causes disease in healthy subjects
● Affects primarily infants, cystic fibrosis, immunocompromise, critically ill, neutropenia and burns / on ventilators
● Immunocompromised usually have paucicellular pattern, rapidly progressive course with bronchopneumonia and bacteremia
● Immunocompetent have a cellular pneumonia, more protracted course
● Perivascular bacterial infiltration is somewhat specific for pseudomonas

Infants:
● Rare: 0.3% of neonatal ICU admissions
● Usually low birth weight (1.2% of low birth weight admissions)
● Mortality 32-87% with death within 1-2 days
● Diagnosis made by culture

Case reports
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● 49 year old woman with fatal pneumonia likely associated with contaminated hot tub (Infection 2011;39:265)

Gross images
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Pseudomonas pneumonia

Micro description
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● Necrotizing pneumonia with 2 patterns - paucicellular coagulative confluent bronchopneumonia with perivascular bacillary infiltration (bacteremic) or cellular pneumonia without evidence of perivascular organisms (non-bactermic)
● Non-bacteremic: often occurs in debilitated patients with chronic lung or heart disease through aspiration

Micro images
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Angioinvasion

Additional references
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● Hum Pathol 2003;34:929

End of Lung-nontumor > Infections > Pseudomonas aeruginosa

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