Dr. Nguyen Thi Phuong Thy, from the Respiratory Unit, General Internal Medicine Department, Tam Anh General Hospital Ho Chi Minh City, reported that in addition to chest pain, the patient had mild shortness of breath upon deep inhalation. Blood tests showed elevated white blood cell and C-reactive protein (CRP) levels. A chest CT scan identified multiple scattered consolidations across both lungs, along with bilateral pleural effusion. These findings indicated extensive pneumonia extending to the pleura.

The patient presented with a minor, swollen, red burn on his lip, for which he had received antibiotic treatment days earlier. "The infection on the lip likely served as a gateway for the bacteria to enter the lungs," Dr. Thy explained. While Staphylococcus aureus typically causes pneumonia by entering through the upper respiratory tract (nose, throat, larynx), this case suggests an alternative route.

Blood culture results confirmed a methicillin-resistant staphylococcus aureus (MRSA) infection. A CT scan showed septic emboli in the lungs, with no other infection sites identified.

Dr. Thy advises the patient on respiratory health monitoring and care during a follow-up appointment. Photo: Tam Anh General Hospital

Following treatment, the patient showed significant improvement: his pleural effusion resolved, chest pain subsided, and he was discharged.

Dr. Thy noted that pneumonia can spread via the bloodstream, not just airborne routes. Bacteria can originate from non-respiratory infection sites like skin boils, infected wounds, or dental inflammation, even if the initial infection was partially treated with antibiotics.

Young patients with severe sepsis-pneumonia often exhibit subtle symptoms, such as an absence of fever or cough, even when the disease is widespread. Doctors recommend seeking medical attention for any unusual symptoms to ensure timely diagnosis and appropriate treatment.

By Nhat Thanh

*Patient's name has been changed