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Fatal abscessing pneumonia caused by oxacillin-resistant Staphylococcus aureus producing Panton-Valentine leukocidin
Authors: P. Petráš 1; M. Rumlerová 2; I. Machová 1; P. Nekvinda 3; P. Beroušková 4
Authors‘ workplace: NRL pro stafylokoky SZÚ–CEM, Praha Vedoucí: RNDr. Petr Petráš, CSc. 1; Laboratoř lékařské mikrobiologie, ZÚ se sídlem v Kolíně pracoviště Kladno Vedoucí: RNDr. Karel Rébl 2; Anesteziologicko-resuscitační oddělení Primář: MUDr. Kamil Kodras 3; Oddělení patologické anatomie Primář: MUDr. Milan Janoušek Oblastní nemocnice Kladno Ředitel: MUDr. Otakar Mareš 4
Published in: Prakt. Lék. 2008; 88(4): 236-239
Category: Case Report
Overview
Toxinogenic strains of Staphylococcus aureus are implicated in a wide range of severe infections. Apart from toxic shock syndrome and toxic dermatitis (pemphigus neonatorum and staphylococcal scalded skin syndrome), infections caused by staphylococci producing Panton-Valentine leukocidin (PVL) have recently become a concern. These infections affect primarily the skin and subcutaneous tissue, often with a long clinical course and final necrosis. An even greater threat is posed by rapidly progressive hemorrhagic necrotizing pneumonia reported also in young immunocompetent persons. Necrotizing pneumonia is associated with high death rates. Here we report a case of fatal abscessing pneumonia in a healthy 22-year-old male. It was caused by a community oxacillin-resistant strain of Staphylococcus aureus producing Panton–Valentine leukocidin. The infection had a rapidly fatal outcome: the patient died within 6 days, i.e. 2 days after admission to hospital. As far as we know, such a case has not yet been reported in the Czech literature.
Key words:
Toxinogenic S. aureus, MRSA, Panton-Valentine leukocidin, abscessing pneumonia.
Sources
1. Beneš, J. Antibiotická léčba pneumonií na JIP z pohledu infektologa. Sborník abstrakt 11. pracovní setkání “Antibiotická politika” Soláň, 2007, 30, s. 1-63.
2. Gillet, Y., Issartel, B., Vanhems, P. et al. Association between Staphylococcus aureus strains carrying gene for Panton-Valentine leukocidin and highly lethal necrotising pneumonia in young immunocompetent patients. Lancet, 2002, 359, p. 753–759.
3. Kravitz, G.R., Dries, D.J., Peterson, M.L., Schlievert P.M. Purpura fulminans due to Staphylococcus aureus. Clin. Infect. Dis. 2005, 40, p. 941–947.
4. Lina, G., Piemont, Y., Godail-Gamot, F. et al. Involvement of Panton-Valentine Leukocidin–Producing Staphylococcus aureus in primary skin infections and pneumonia. Clin. Infect. Dis. 1999, 29, p. 1128–1132.
5. Lopez, A., Perez-Roth, E., Mendes-Alvaris, S. Association between the presence of Panton-Valentine Leukocidin-encoding gene and a lower rate of survival among hospitalized pulmonary patients with staphylococcal disease. J. Clin. Microbiol. 2007, 45 (1), p. 274–276.
6. Machová, I., Petráš, P. První potvrzení přítomnosti genů kódujících Pantonův-Valentinův leukocidin u českých kmenů Staphylococcus aureus. Zprávy CEM (SZÚ, Praha), 2004, 13, 9, s. 387–388.
7. Machová, I., Petráš, P., Blažková, E., Kňapová, L. Sledování genů kódujících Pantonův-Valentinův leukocidin u kmenů Staphylococcus aureus. Epidemiol. Mikrobiol. Imunol. 2007, 56, č.2, s. 88-93.
8. Reichert, B., Birrell, G. Severe non-pneumonic necrotising infections in children caused by Panton–Valentine Leukocidin producing Staphylococcus aureus strains. J. Infect. 2005, 50, p. 438-442.
9. Health Protection Agency PVL Working Group, Department of Health, UK:
Interim guidance on diagnosis and management of PVL–associated Staphylococcal infections in the UK [on line]. 2007-03-13 [cit. 2008-04-11]. Dostupný na WWW:
http://www.dh.gov.uk/en/Aboutus/MinistersandDepartmentLeaders/ChiefMedicalOfficer/Features/DH_4133761
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Article was published inGeneral Practitioner
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