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Case Reports
. 2023 Oct 12:2023:9930291.
doi: 10.1155/2023/9930291. eCollection 2023.

Carbapenem-Resistant Acinetobacter baumannii Bloodstream Infection in a Ghanaian Patient with Unilateral Diaphragmatic Eventration and HIV Type 1 Infection

Yvonne Ayerki Nartey  1   2 , Augustine Boakye Donkor  3 , Ampem Darko Jnr Siaw  1 , Oluwayemisi Esther Ekor  4 , Bashiru Babatunde Jimah  5
Affiliations
Case Reports

Carbapenem-Resistant Acinetobacter baumannii Bloodstream Infection in a Ghanaian Patient with Unilateral Diaphragmatic Eventration and HIV Type 1 Infection

Yvonne Ayerki Nartey et al. Case Rep Infect Dis. .

Abstract

Carbapenem-resistant Acinetobacter baumannii infection is a critically prioritized pathogen by the World Health Organization and a cause for growing concern due to increased mortality among hospitalised patients. Phrenic nerve palsy is a rare complication of herpes zoster infection of the C3, C4, and C5 nerve roots. We present a case of bloodstream carbapenem-resistant A. baumannii infection in a Ghanaian patient with HIV type 1 infection and multiple risk factors, including unilateral diaphragmatic eventration with compression atelectasis likely secondary to phrenic nerve palsy due to herpes zoster infection, consequently leading to recurrent hospital and ICU admission. In this case, we emphasize the need for clinicians in LMICs to be aware of CRAB, in order to advocate for the availability of evidence-based medicines in resource-limited settings for appropriate treatment. In addition, we illustrate the importance of a high index of suspicion for infection with carbapenem-resistant organisms such as A. baumannii and highlight a rare and severe complication of herpes zoster infection in the form of phrenic nerve palsy and consequent diaphragmatic eventration.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Axial and coronal reformatted CT scan images of the chest, mediastinal window. The images show dense consolidation with air bronchograms in the left lower lobe consistent with pneumonia. There is associated significant fluid in the left pleural space, in keeping with parapneumonic effusion. The coronal image shows ∼7.8 cm elevation of the left hemidiaphragm relative to the right hemidiaphragm, resulting in severe left lung volume loss and mediastinal shift to the right.
See this image and copyright information in PMC

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