Characteristics of Nonbacteremic Pseudomonas Pneumonia

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Abstract
The distinguishing clinical course, laboratory findings, and morbid anatomy of non-bacteremic Pseudomonas pneumonia is described. These infections occurred in 10 patients (8 of whom ultimately died) who were admitted to the Detroit General (Receiving) Hospital during a 30 month surveillance during 1963-1965. Chronic lung or heart disease were cardinal predisposing conditions which apparently increased their susceptibility to infection with Bacillus [Pseudomonas] pyocyaneus. In a few prior administration of antibiotics may have contributed to colonization of upper respiratory passages by Pseudomonas. Apprehension, confusion, cyanosis, relative bradycardia, reversal of the uusal diurnal temperature curve and abnormal liver and kidney function was striking. At X-ray a diffuse nodular lowerlobe bronchopneumonia with microabscesses was seen. Pathologically, microabscesses and focal hemorrhage were noted. There was no necrotizing bacillary vasculitis, nor thrombosis or pulmonary vessels as when the lungs are involved by Psdueomonas bacteremia. The severe toxicity and the pathogenesis of the pulmonary lesions in these patients are probably induced by local production and subsequent circulation of elastase, hemolysin, lecithinase, and lipase elaborated by these bacilli.

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