PMC5763093_01
(a) Cross section of CT chest showing a right upper lobe cavitary lesion. (b) Respiratory cultures plated on blood and soy agar. (c) Humidifier with film inside water basin. (d) Humidifier culture on blood agar showing colony growth with pigment.
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His initial chest x-ray was abnormal, so a CT chest with contrast was obtained, which demonstrated a 2.9 cm right upper lobe cavitary lesion (Figure 1(a)). Cultures of bronchoalveolar lavage, washings, and tissue culture performed during bronchoscopy resulted with heavy growth of P. aeruginosa (Figure 1(b)). It was noted to have a thin gray-green film coating the plastic covering as well as standing water in the basin (Figure 1(c)). We obtained cultures of the humidifier water and basin, which both returned positive for P. aeruginosa (Figure 1(d)).