Unresolving Pneumonia in Type 2 Diabetes: Case Report of Polymicrobial Lung Disease
Abstract
Polymicrobial pneumonia caused by the simultaneous infection with multiple pathogens is increasingly recognized in individuals with comorbidities such as type 2 diabetes mellitus (T2DM). The immunocompromised state associated with T2DM predisposes patients to both typical and opportunistic infections, including multidrug‐resistant bacteria and fungi. Prompt diagnosis and organism‐specific treatment are critical for optimal outcomes. We report the case of a 53‐year‐old male with newly diagnosed T2DM who presented with a 3‐month history of left‐sided chest pain, dry cough, dyspnoea, and persistent fever. Initial empirical antibiotic therapy was ineffective. Imaging revealed a massive loculated left pleural effusion with compressive atelectasis. Pleural fluid analysis identified a polymicrobial infection involving multidrug‐resistant Klebsiella pneumoniae, Enterobacter spp. with inducible AmpC resistance, and azole‐resistant Candida glabrata. Intravenous meropenem, echinocandin antifungal therapy, and subsequent oral fluconazole were recommended for successful treatment. Glycaemic control was concurrently optimized with insulin therapy. This case emphasizes the importance of considering polymicrobial infections in diabetic patients presenting with unresolving pneumonia. Early use of imaging and pleural fluid analysis enabled prompt identification of the causative organisms, guiding tailored antimicrobial therapy. Multidisciplinary management is essential in improving outcomes…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Levofloxacin-Induced Tendon Rupture: A Case Report and Review of the Literature
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
- Neuroprotective Effects of Epicatechin against Oxidative Stress-Induced Cognitive Impairment: A Systematic Review and Meta-Analysis
- Quality evaluation and in vitro interaction studies between levofloxacin 250mg and diclofenac sodium 50mg tablets
- Molecular Epidemiology of mcr-1 -Positive Polymyxin B-Resistant Escherichia coli Producing Extended-Spectrum β-Lactamase (ESBL) in a Tertiary Hospital in Shandong, China
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.