[A case of pneumonia due to Enterococcus faecium after near drowing].

Abstract

A 73-year-old man admitted for near drowning was found after 24 hours of mild therapeutic hypothermia to have pneumonia. Blood gas analysis showed metabolic acidosis, hypercapnia, and hyponatremia. Chest X-ray and computed tomography (CT) showed bilateral mainly lower-lobe consolidation. After being treated with 13.5 g of tazobactam/piperacillin and 1.0-1.25 g of vancomycin per day for two weeks, the man recovered from his severe respiratory failure. Enterococcus faecium was isolated twice from sputum and raising the dose of vancomycin was effective, but it took 10 days to wean him from ventilator support. While this case may be rare, therapeutic hypothermia and near drowning together were considered predisposing factors in the severity of the pneumonia caused by E. faecium. The possibility of pneumonia due to vancomycin-resistant Enterococci should thus be considered in similar cases.