Pseudomonas aeruginosa pneumonia

　　Etiology

　　1. Pseudomonas aeruginosa is also known as Pseudomonas stutzeri. This disease has become a relatively common pathogen in respiratory diseases in recent years.

　　2. Second only to Escherichia coli, Pseudomonas aeruginosa, Klebsiella, Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and others.

　　Patients with severe sepsis or septicemia may develop septic shock, with high fever, but also with no rise in body temperature, decreased blood pressure, cold extremities, excessive sweating, and cyanosis of the lips.

　　When complicated with myocarditis, tachycardia may occur with arrhythmias such as premature beats, paroxysmal tachycardia, or atrial fibrillation.

　　When complicated with pleurisy, the pleural fluid is serofibrinous exudate; there were also reports of complicated empyema before the use of penicillin.

　　At the same time, pneumococcal infection can also cause acute exacerbation of chronic bronchitis, and diseases such as arthritis and conjunctivitis. With the use of antibiotics, severe complications have become less common in recent years.

　　Among a group of 24 patients reported, there were 18 males and 6 females, with an average age of 58.17 years (from 1 year and 5 months to 79 years), and 14 cases were over 60 years old (58.3%).

　　Symptoms:11 cases of fever (8 cases with body temperature above 38℃), 20 cases of cough, 9 cases of white sputum, 10 cases of yellow sputum, 9 cases of increased sputum volume, 10 cases of decreased sputum volume, 17 cases of asthma, 4 cases of chest pain, 1 case of decreased appetite.

　　II. Physical (specific) signs:Rales in 13 cases, cyanosis in 15 cases, clubbing in 3 cases, oliguria in 2 cases, decreased breath sounds in 5 cases, edema in 2 cases.

　　From Yao's 30 cases, Wang's 33 cases, and the author's 24 cases, the characteristics of this bacterium pneumonia are as follows:

　　1. Infection age ranges from infants to the elderly, but is more common in people over 60 years old.

　　2. Most patients have incurable underlying diseases with poor immune function.

　　3. This bacterium can be acquired from the community as well as from the hospital.

　　4. The clinical manifestations of lower respiratory tract infection by this bacterium have no special features.

　　5. Chest X-ray shows no special features, patchy shadows are more common.

　　6. A significant number of patients have abnormal liver and kidney function tests, but most patients have underlying diseases, it is difficult to determine the cause.

　　7. Difficult to treat, high antibiotic resistance rate, poor efficacy.

　　8. Poor prognosis, among the 24 cases, 1 case was cured, 14 cases improved, 7 cases died due to infection, 2 cases left the hospital automatically in critical condition, 17 cases of persistent neutropenia in Vartivarian's 26 cases, 9 cases of septic shock or multiple organ failure, and a characteristic of 5 cases with sinusitis (paranasal sinus) and pneumonia (sinus pneumonia syndrome).

　　Strengthening physical exercise, improving physical fitness, can reduce the occurrence of the disease, such as chronic cardiovascular and pulmonary diseases, chronic liver disease, diabetes, and oropharyngeal diseases, should be actively treated, which can reduce the chance of triggering the disease. At the same time, for family members with infections, active treatment should be sought, other family members should wear masks to reduce the chance of infection, and patients should also wear masks to reduce the excretion of pathogens to the outside. Through the above treatment, infection can be reduced.

　　Among the 26 cases of Vartivarian's white blood cell classification count, 17 had persistent neutropenia, and the bacterial culture was mostly a mixed strain, with both bacteria and fungi.

　　Early chest X-ray films are mostly patchy segmental pneumonia or unilateral lobar pneumonia, with some progressing to multiple nodular infiltrates in both lungs (6 cases). Among the 24 cases, there were 16 cases of patchy shadows, 8 cases of rough texture, 4 cases of spherical shadows and abscesses, 1 case of cavity, and 2 cases of pneumothorax.

　　I. Therapeutic diet for Xanthomonas oryzae pneumonia

　　1. Stir-fried crucian carp with celery:250 grams of crucian carp, 50 grams of fresh celery, starch, ginger slices, scallion slices, soy sauce, sugar, vinegar, MSG, cooking wine, pickled chili peppers, and vegetable oil as needed. Preparation involves cutting the crucian carp into strips, cutting the celery into segments, and mixing soy sauce, sugar, vinegar, MSG, cooking wine, salt, and starch with chicken broth to make a sauce. Heat the wok over high heat, add oil and heat to 5 degrees, then add the fish strips and stir-fry until they separate, drain off the excess oil, and add ginger slices and pickled chili peppers. Stir-fry the celery segments until fragrant, then add the sauce, add some glossy oil, and remove from heat. Benefits include clearing heat and detoxifying, diuretic, reducing cough and phlegm, etc. Celery has the effects of calming the liver and clearing heat, dispelling wind and moistening dampness, nourishing the spirit and benefiting the body. The combination of crucian carp and celery is suitable for the auxiliary treatment of acute and chronic pneumonia.

　　2. Rabbit meat and mushroom shreds:Ingredients: 100 grams of cooked rabbit meat, 50 grams of mushrooms, 25 grams of scallion, chili oil, soy sauce, vinegar, sugar, sesame oil, sesame paste, chili powder, and monosodium glutamate. Preparation: slice the cooked rabbit meat and scallion, and cook the mushrooms. Place the scallion and mushrooms at the bottom, cover with rabbit slices, and serve in a dish. Use soy sauce to disperse the sesame paste little by little, mix the sesame oil evenly to make a sauce, and pour it over the rabbit slices. Effects: rabbit meat has the effects of clearing heat and detoxifying, benefiting the spleen and Qi, removing dampness and cooling the blood, and promoting defecation; mushrooms have the effects of detoxifying and moistening the dryness, benefiting the spleen and Qi, removing dampness and stopping diarrhea. Eating rabbit meat and mushrooms together is suitable for treating acute pneumonia.

　　3. Quail and lily soup:Ingredients: 1 quail, 25 grams of lily, ginger, scallion, monosodium glutamate, and fine salt. Preparation: kill the quail, remove the feathers, feet, and internal organs, wash it, and blanch it in boiling water, then take it out and cut it into pieces; separate the lily into petals, wash it, and set it aside. Wash the ginger and scallion, beat the ginger, and cut the scallion into sections. Place the pot on a high heat, add some water, add the quail, bring it to a boil, add lily, ginger pieces, and scallion sections, then turn the heat to low and simmer until the quail is cooked. Add salt and monosodium glutamate, simmer for a few minutes, and serve in a soup bowl. Effects: quail meat has the effects of benefiting the five internal organs, clearing the liver and lungs, clearing heat and promoting diuresis, and stopping diarrhea; lily has the effects of moistening the lungs and stopping cough, nourishing the Yin and clearing heat, calming the mind. Eating both together is suitable for acute and chronic pneumonia.

　　4. Lean meat and cabbage soup:Ingredients: lean meat, 100 grams of cabbage heart, a little ginger, garlic, salt, monosodium glutamate, and chicken oil. Preparation: slice the lean meat, wash and slice the cabbage, and put it in boiling water until it is just cooked, then take it out and rinse it with cold water, drain the water and set aside. Place the pot on a high heat, add chicken oil and heat it to five degrees, add garlic and stir-fry until golden, then add the lean meat and stir-fry together, add fine salt, add soup to cook, then add the cabbage heart to boil, add monosodium glutamate and it is ready to eat. Effects: lean meat has the effects of replenishing the middle and benefiting the Qi, promoting saliva and moistening the intestines; cabbage is mild in nature and sweet in taste, with the effects of clearing heat and detoxifying, resolving phlegm and stopping cough, relieving restlessness and promoting defecation. Eating lean meat and cabbage together is suitable for acute and chronic pneumonia.

　　Two, what foods are good for the body for Mycobacterium oryzae pneumonia?

　　1. Foods should be high in nutrition, light, and easy to digest, in a liquid form, especially juice.

　　2. Fresh fruits and vegetables.

　　3. Foods rich in oil, eggs, and other foods rich in vitamin A.

　　Three, what foods should not be eaten for Mycobacterium oryzae pneumonia?

　　1. Avoid spicy and greasy foods:Do not eat large fish, meat, and overly greasy foods. Patients with pneumonia should not add spices such as chili, pepper, mustard, and Sichuan pepper to their diet. Quit smoking and drinking.

　　2. Not suitable for sweet and warm fruits:Such as peaches, apricots, plums, oranges, etc.

　　3. Avoid cold and cold foods:A variety of ice drinks; melons and fruits with cold properties, including watermelons, pears, bananas, kiwis, etc.; secondly, avoid eating sour foods: such as vinegar, sauerkraut, pickles, and hawthorn, black plums, sour tangerines, etc.; astringent foods: such as white sesame seeds, lotus root nodes, and unripe persimmons, crabapples, etc.

　　(The above information is for reference only, please consult a doctor for details.)

　　1. Treatment

　　The low permeability of the outer membrane of this kind of bacteria makes it naturally resistant to a variety of antibiotics, especially to beta-lactam antibiotics, which is due to the fact that the bacteria can produce penicillinase, cephalosporinase, and zinc ion-containing metal beta-lactamase. The unique hydrolytic function of the metal beta-lactamase on the broad-spectrum antibiotic imipenem makes routine empirical medication rarely effective. The 88 strains of bacteria tested by Gui Bindong showed an induction rate of beta-lactamase of 60.2%. The 38 strains of Dalian Central Hospital tested by Wang Chengmin showed an induction rate of 89.5%, and his sensitivity rates for 23 antibiotics were as follows: sulfamethoxazole/trimethoprim (sulfamethoxazole/trimethoprim) (78.6%), ticarcillin/clavulanate potassium (ticarcillin/clavulanate potassium) (42.8%), ciprofloxacin (66.7%), ceftriaxone (48.2%), azlocillin (42.1%), cefoperazone/sulbactam (sulperazon) (41.3%). There are 15 antibiotics with resistance rates greater than 60% (65.2%) to this kind of bacteria. The drug sensitivity results of the 14 antibiotics tested by the author were: sulfamethoxazole/trimethoprim (sulfamethoxazole/trimethoprim) (79.17%), ciprofloxacin (45.83%), ticarcillin/clavulanate potassium (ticarcillin/clavulanate potassium) (41.66%), polymyxin (20.83%), and ceftriaxone (16.66%), amikacin (4.17%) were all below 20%, and imipenem was 100% resistant. Vartjvarian's cases show that the timing of treatment initiation has a significant impact on prognosis. Seven of the 10 patients who received appropriate antibiotic treatment within the first 3 days of infection survived, while only 4 of the 16 control group patients survived after treatment 3 days after the onset of infection (P=0.04).

　　The treatment of this kind of pneumonia includes: first, selecting sensitive antibiotics; second, comprehensive treatment of the underlying disease and pneumonia, regulating immune function, and improving supportive treatment. When even third-generation cephalosporins and aminoglycoside antibiotics, as well as imipenem/cilastatin sodium (Tigan), are ineffective, the possibility of this kind of bacterial infection should be considered.

　　2. Prognosis

　　Poor prognosis.