Bacteremic Escherichia coli pneumonia.

Nine patients with bacteremia Escherichia coli pneumonia were studied, and 22 cases from the literature of the bacteremic and nonbacteremic variety were reviewed. The findings of this study indicate that E coli pneumonia most often occurs in persons who are elderly and have associated conditions that impair host defenses. Escherichia coli pneumonia is usually nosocomially acquired. The organism may reach the respiratory tract by aspiration of oropharyngeal secretions due to colonization or by hematogenous dissemination from a primary source in the gastrointestinal tract or the genitourinary tract. The clinical manifestation most often is that of pneumonia in the lower lobe, but the process can be roentgenographically variable. Sputum culture is usually positive in the bacteremic form of E coli pneumonia. The high morbidity found in this study, despite appropriate antimicrobial therapy, emphasizes the need for earlier recognition and infection prevention in predisposed groups.