What are the symptoms of Pseudomonas aeruginosa infection

Pseudomonas aeruginosa is a common bacterium in nature. It has low pathogenicity but strong drug resistance. If the wound is not thoroughly disinfected, it will be infected with Pseudomonas aeruginosa, causing suppuration and the production of green pus. Pseudomonas aeruginosa not only exists on human skin, but is also widely distributed in the human intestinal respiratory tract. Therefore, Pseudomonas aeruginosa infection manifests itself in many symptoms.

1. Sepsis

Pseudomonas aeruginosa sepsis is often secondary to large-area burns, leukemia, lymphoma, malignant tumors, tracheotomy, intravenous catheters, heart valve replacement and various serious chronic diseases. Sepsis caused by this bacterium accounts for about 7% to 18% of Gram-negative bacillus sepsis, ranking third or fourth, and the mortality rate ranks first. Its clinical course is similar to other Gram-negative bacillus sepsis. Except that premature infants and young children may not have fever, patients may have remittent or retained fever, often accompanied by shock, adult respiratory distress syndrome (ARDS) or disseminated intravascular coagulation (DIC), etc. Characteristic deep gangrenous pustules may appear on the skin, surrounded by erythema. 48 to 72 hours after the appearance of the rash, the center is gray-black gangrene or ulcer, and there are bacterial thrombi in the small blood vessels. Bacteria can be easily found by Gram staining or culture of the exudate smear. The rash can occur anywhere on the body, but it is more common in the perineum, buttocks or axilla, and occasionally in the oral mucosa. Acromigratory abscesses may occur in the late stage of the disease.

2. Respiratory tract infection

Primary Pseudomonas aeruginosa pneumonia is rare and often occurs secondary to impaired host immune function, especially on the basis of existing chronic lung diseases, such as chronic bronchitis, bronchiectasis, tracheotomy, and the use of artificial respirators. X-ray manifestations are scattered bronchopneumonia on both sides with nodular exudative shadows, and empyema rarely occurs. Patients secondary to sepsis are in critical condition, and lesions caused by necrosis of small muscular arteries or veins can be seen in the lungs. The type is similar to erythema gangrenosum, and the mortality rate is extremely high. Chronic Pseudomonas aeruginosa lung infection often occurs in patients with cystic fibrosis, often accompanied by chronic cough, sputum and progressive lung function impairment.

3. Endocarditis

It often occurs on the basis of existing heart disease, after heart surgery, and valve replacement. Bacteria are often inoculated on wound sutures or patches. It can also occur on normal heart valves in patients with burns or drug addiction. The lesions can affect all heart valves, but the tricuspid valve is more common. If the vegetation affects the left heart valve, the prognosis is more serious. Compared with endocarditis caused by viridans streptococci, the drug cure rate of this disease is low. Even with sensitive antibiotics, the cure rate is still less than 30%. Therefore, surgery should be performed as soon as possible to remove the vegetation and replace the diseased valve.

4. Urinary tract infection

Pseudomonas is a common bacteria in hospital-acquired urinary tract cross-infection, ranking second in the number of bacteria isolated from the urinary tract in hospital-acquired infections. Indwelling urinary catheter is a predisposing factor for infection in paraplegic patients. Other patients with neurogenic bladder, urinary tract obstruction, and chronic urinary tract infection who receive long-term antibiotic treatment are also susceptible to Pseudomonas infection. The primary cause of 40% of Pseudomonas aeruginosa sepsis is urinary tract infection.

5. Central nervous system infection

It is mainly caused by Pseudomonas aeruginosa, manifested as meningitis or brain abscess, often secondary to craniocerebral trauma, head and neck tumor surgery, lumbar puncture or ventricular drainage surgery, and can also spread from ear, mastoid, and sinus infections. Neutropenia and severe burns are risk factors for Pseudomonas aeruginosa sepsis to migrate to the brain. The clinical manifestations are the same as other bacterial central infections, but the prognosis is poor, with a mortality rate of over 60%.

6. Bone and joint infections

Mainly due to the hematogenous migration of sepsis or infection lesions from adjacent tissues, complicated urinary tract infections in the elderly and urogenital surgery or instrument operations can cause multiple vertebral osteomyelitis. In recent years, it has been reported that people who inject heroin often develop cervical osteomyelitis. The clinical course is no special, with less pain and a poor prognosis.

7. Eye infection

Pseudomonas aeruginosa is one of the common pathogens of corneal ulcers or keratitis, which often occurs secondary to eye trauma or corneal abrasion during threshing of rice in rural areas. Pseudomonas aeruginosa contamination of contact lenses or lens fluid is another important way for this bacteria to infect the eyes. The infection develops rapidly and can spread to the entire eye within 48 hours. It can quickly cause corneal dissolution and should be treated urgently, otherwise it can easily cause blindness.

8. Ear, mastoid and sinus infections

After swimming, the pH of the external auditory canal becomes alkaline due to the entry of water, which is conducive to the growth of Pseudomonas aeruginosa and causes external otitis. People with diabetes and vascular disease may occasionally develop chronic, painless, malignant external otitis caused by Pseudomonas aeruginosa. If not treated in time, the consequences are poor. Otitis media and mastoiditis caused by this bacteria are often secondary to malignant external otitis or acute otitis media. When there is diabetes or other diseases, Pseudomonas aeruginosa can pass through the vascular sheath and cause intracranial infection.

9. Skin and soft tissue infection

Patients with sepsis may develop secondary skin lesions such as erythematous gangrene rash, subcutaneous nodules, deep abscesses, cellulitis, etc. Pseudomonas aeruginosa can often be cultured on burn wounds, bedsores, traumatic wounds and varicose ulcers.

10. Digestive tract infection

Pseudomonas aeruginosa can cause lesions in any part of the digestive tract, and is common in infants and young children as well as immunocompromised individuals with granulocytopenia caused by tumor chemotherapy. It can cause diarrhea in infants and young children and appendicitis or rectal abscess in adults. Pseudomonas aeruginosa infection in the digestive tract is also one of the important invasion portals of sepsis.