Title

Escherichia Coli Lobar Pneumonia: Fatal Infection in a Mentally Retarded Patient

Volume

89

Publication Date / Copyright Date

1996

First Page

628

Last Page

630

Abstract

Lobar pneumonia due to Escherichia coli is rare. Most lobar pneumonias are caused by either Streptococcus pneumoniae or Klebsiella pneumoniae, and most E coli pneumonias are bronchopneumonias. We report an acute fulminant course of E coli lobar pneumonia in a 37-year-old patient who was profoundly retarded, institutionalized, and nonimmunosuppressed and who died within 2 days of developing initial symptoms. Antemortem blood and postmortem blood and lung specimens isolated pure cultures of E coli. The source of infection in E colilobar pneumonia is not clear in this patient or in the few cases that have been reported. We postulate that nasopharyngeal colonization of E coli in those who are institutionalized with mental retardation may predispose these patients to E coli pneumonia. Our case illustrates features of pneumonias that are unique in the institutionalized, mentally retarded patient population (ie, the relatively high prevalence of nasopharyngeal colonization of E coli, a higher incidence of E coli pneumonia than in other institutionalized populations, the often fulminant course of the disease), as well as the need for early, aggressive treatment including antibiotics effective against gram-negative bacteria.

Disciplines

Medicine and Health Sciences

Keywords

pneumonia, escherichia coli infections, disability, adult

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