Severe Pneumonia Caused by Streptococcus Pneumoniae and Haemophilus Influenzae Coinfection in an Elderly Patient: A Case Report

An 80-year-old man was admitted to our hospital because of worsening dyspnea, fever and sputum. Both chest X-ray film and computed tomography findings showed localized consolidation of the right lower lung. A urine sample was positive for Streptococcus pneumoniae antigen. After initial treatment with meropenem for 3 days, his symptoms improved and high-dose ampicillin was substituted for meropenem. However, 3 days later he required intubation for adult respiratory distress syndrome. We reinstituted meropenem therapy and this proved successful. Sputum culture revealed coinfection with penicillin sensitive S. pneumoniae and beta-lactamase-negative ampicillin-resistant Haemophilus influenzae . doi: http://dx.doi.org/10.4021/jmc843w