title: [Pneumothorax with reduced pulmonary function complicated by MRSA pneumonia: a case report].
abstract: The occurrence of pneumothorax in patients with compromised lung function or severe pulmonary disease may be fatal. We describe a 77-year-old patient with MRSA pneumonia complicated by pneumothorax and reduced pulmonary function. Although the patient was treated with drainage of the pleural cavity and nonsurgical pleurodesis, the pneumothorax could not be managed successfully. The patient underwent successful surgical treatment of the pneumothorax on 105 days after onset. The following factors must be considered in the surgical treatment of pneumothrax with reduced pulmonary function in patients with MRSA pneumonia: 1) When there is massive air leakage, adequate doses of VCM should be administered to prevent pyothorax, 2) when conservative treatment fails and surgical treatment becomes necessary, the operation should be instituted only when MRSA has been completely or almost completely eradicated so as to prevent the occurrence of postsurgical pyothorax, and 3) surgical intervention should be limited to what is necessary to repair the site of ruptured bulla; care should be exercised to preserve as much lung parenchyma as possible and to shorten the operation time.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Kansai Medical University, Moriguchi, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Saitoh
authors.forename: H
authors.initials: H
authors.lastname: Nakamura
authors.forename: K
authors.initials: K
authors.lastname: Kagawa
authors.forename: M
authors.initials: M
authors.lastname: Umemoto
authors.forename: H
authors.initials: H
authors.lastname: Imamura
mesh_terms: D000368:Aged; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D016106:Methicillin Resistance; D011023:Pneumonia, Staphylococcal / Q000150:complications* / Q000503:physiopathology; D011030:Pneumothorax / Q000503:physiopathology / Q000601:surgery*; D013211:Staphylococcus aureus / Q000187:drug effects*