| Community-acquired pneumonia with Pseudomonas aeruginosa in a geriatric patient with rheumatoid arthritis under baricitinib treatment |
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Eva Grundmann1, Ghazala Gohar1, Simon Meier1, Bertram Feil2, Michael Gagesch1,3 |
1Stadtspital Zürich, Universitäre Klinik für Altersmedizin, Zurich, Switzerland
2Stadtspital Zürich, Institut für Radiologie und Nuklearmedizin, Zurich, Switzerland
3Center on Aging and Mobility, University of Zurich, Zurich, Switzerland |
Correspondence:
Ghazala Gohar,
Email: ghazala.gohar@stadtspital.ch
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Received: 14 December 2024 • Revised: 15 March 2025 • Accepted: 1 May 2025 |
| Abstract |
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Community-acquired pneumonia (CAP) in older patients present unique diagnostic challenges. Unlike typical presentations with fever and cough, older patients may experience atypical symptoms like falls, confusion, or chronic disease deterioration. Immunomodulatory treatments for autoimmune diseases increase infection risks. This is the first case of a severe Pseudomonas aeruginosa pneumonia in an 86-year-old patient with rheumatoid arthritis on baricitinib and prednisone. Initially admitted after a fall, she showed no respiratory symptoms but had a chest x-ray revealing an extensive infiltrative consolidation. Bronchial secretion analysis confirmed the pneumonia, which was successfully treated with antibiotics. Following the resolution of the infection, the immunomodulatory therapy could be safely reintroduced. The case emphasizes the critical need for comprehensive diagnostic evaluation in older adults on immunomodulatory therapy, showing that subtle, non-respiratory symptoms can mask serious infections and require heightened awareness. |
| Key Words:
Pseudomonas aeruginosa, baricitinib, rheumatoid arthritis |
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