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Persistence of P seudomonas aeruginosa in a pulmonary nodule with late relapse
Author(s) -
Ronkainen S.,
Xie Y.,
Battiwalla M.,
Barrett A.J.,
Stock F.,
Dekker J.P.,
Danner R.L.
Publication year - 2014
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12253
Subject(s) - medicine , nodule (geology) , bronchoalveolar lavage , hematopoietic stem cell transplantation , lung , transplantation , pathology , paleontology , biology
Lung nodules are common diagnostic challenges in hematopoietic stem cell transplantation and solid organ transplantation. P seudomonas aeruginosa is a known cause of lung abscess in these patients, but its ability to persist for months in a quiescent lung nodule and later cause recurrent infection is not well known or documented. A patient with a history of acute pre‐B‐cell lymphoblastic leukemia had enlargement and cavitation of a small right upper lobe pulmonary nodule 10 months after allogeneic hematopoietic stem cell transplantation. The nodule was the remnant of a presumed P . aeruginosa septic embolus that occurred 2.5 months after transplantation. With antibiotic treatment, the nodule had shrunk in size to <1 cm and remained stable. Transthoracic needle aspiration grew P . aeruginosa indistinguishable by molecular typing from isolates obtained 7.5 months earlier from blood and bronchoalveolar lavage fluid. Sub‐centimeter pulmonary nodules attributable to previously treated P . aeruginosa may harbor viable organisms and lead to recrudescent infection.