Consilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum9684610.26442/20751753.2019.11.190689Research ArticlePulmonary infarction combined with nosocomial infection with Klebsiella pneumoniae in a senile patientMaltsevaOlga A.doctor*nicolau-olga@mail.ruKharitonovMikhail A.D. Sci. (Med.), Prof.-SalukhovVladimir V.D. Sci. (Med.)vlasaluk@yandex.ruNikolaevAndrei V.Cand. Sci. (Med.)Nikolaevpulmdoc@mail.ruBogomolovAleksei B.Cand. Sci. (Med.)-MorozovSergei L.Cand. Sci. (Med.)-ShevelevAndrei A.Cand. Sci. (Med.)-Kirov Military Medical Academy151120192111767919012022Copyright © 2019, Consilium Medicum2019A clinical case of successful treatment of pulmonary embolism in an elderly patient is presented. The course of the disease was complicated by nosocomial infection Klebsiella pneumoniae with the formation of a lung infarction and destruction of lung tissue. Infarction-pneumonia proceeded on an unfavorable background, the patient was diagnosed with atrial fibrillation and infectious-toxic nephropathy. The source of thromboembolism in the inferior Vena cava system was established. The combination of lung infarction and pneumonia caused by K. pneumoniae is one of the main features of this observation, since each disease itself can lead to a lung abscess. The importance of bacteriological research aimed at verification of the causative agent of pneumonia was noted. Taking into account the revealed multiresistance of the pathogen, traditional antibacterial drugs at the first stages of treatment were ineffective.Klebsiella pneumoniaelung infarctionnosocomial pneumoniaKlebsiella pneumoniaelung abscesspulmonary embolismинфаркт легкогонозокомиальная пневмонияабсцесс легкоготромбоэмболия легочной артерии[Авдеев С.Н. Тромбоэмболия легочных артерий. Пульмонология и аллергология. 2009; 3: 2-9. @@Avdeev S.N. Tromboemboliia legochnykh arterii. Pul'monologiia i allergologiia. 2009; 3: 2-9 (in Russian).][Казанцев В.А. Внебольничные пневмонии: диагностика и лечение. Мед. совет. 2012; 11: 22-9. @@Kazantsev V.A. Vnebol'nichnye pnevmonii: diagnostika i lechenie. Med. sovet. 2012; 11: 22-9 (in Russian).][Бобылев А.А., Рачина С.А., Авдеев С.Н. и др. Этиология внебольничной пневмонии у лиц с хронической сердечной недостаточностью. Пульмонология. 2019; 29 (3): 293-301. @@Bobylev A.A., Rachina S.A., Avdeev S.N. et al. Etiologiia vnebol'nichnoi pnevmonii u lits s khronicheskoi serdechnoi nedostatochnost'iu. Pul'monologiia. 2019; 29 (3): 293-301 (in Russian).]][Степаненко И.А., Салухов В.В., Кицышин В.П. и др. Случай тромбоэмболии легочной артерии с развитием инфаркт-пневмонии на фоне наследственной тромбофилии и уровазального конфликта у молодого мужчины. Известия Российской Военно-медицинской академии. 2018; 37 (3): 27-33. @@Stepanenko I.A., Salukhov V.V., Kitsyshin V.P. et al. Sluchai tromboembolii legochnoi arterii s razvitiem infarkt-pnevmonii na fone nasledstvennoi trombofilii i urovazal'nogo konflikta u molodogo muzhchiny. Izvestiia Rossiiskoi Voenno-meditsinskoi akademii. 2018; 37 (3): 27-33 (in Russian).]][Баранов В.Л., Куренкова И.Г., Николаев А.В. Тромбоэмболия легочной артерии. СПб.: ЭЛБИ-СПб, 2007. @@Baranov V.L., Kurenkova I.G., Nikolaev A.V. Pulmonary embolism. Saint Petersburg: ELBI-SPb, 2007 (in Russian).][Wongsurakiat P, Chitwarakorn N. Severe community-acquired pneumonia in general medical wards: outcomes and impact of initial antibiotic selection. BMC Pulm Med 2019; 19 (1): 179.][Durdu B, Meric K.M, Hakyemez I.N et al. Risk Factors Affecting Patterns of Antibiotic Resistance and Treatment Efficacy in Extreme Drug Resistance in Intensive Care Unit-Acquired Klebsiella Pneumoniae Infections: A 5-Year Analysis. Med Sci Monit 2019; 25: 174-83]