[Severe community-acquired Acinetobacter pneumonia].

A 62-year-old man with atrial fibrillation, hypertension, and fatty liver was admitted to a hospital in October 2002 complaining of productive cough and fever up to 38 degrees C for 2 days. He was a heavy smoker and drank alcohol regularly. He was dyspneic at rest, and chest radiography showed lobar pneumonia in the right upper lobe. Despite the administration of antibiotics, his condition deteriorated rapidly, and he was transferred to our hospital on the next day. On admission, he had multi-lobar pneumonia, septic shock, and disseminated intravascular coagulation. Despite the ventilatory support and the administration of carbapenem, macrolides, and catecholamine, he died 9 hours after admission. Later, all cultures from sputum and blood grew Acinetobacter species. Although community-acquired Acinetobacter pneumonias are rarely reported in Japan, physicians must be aware of this disease because of its fulminant clinical course and high mortality.