Destructive pulmonary embolism in a patient with community-acquired staphylococcal bacteremia.
We report a 17-year-old man with destructive pulmonary embolism caused by Staphylococcus aureus bacteremia. The patient was not immunocompromised and had neither underlying diseases nor risk factors, such as concomitant influenza viral infection, which exacerbate staphylococcal infections. The rapid and extensive progression of pulmonary involvement in all lung fields make this a rare case; there have been few reports in the literature describing a similar radiographic appearance in patients with community-acquired staphylococcal bacteremia. In-vitro studies did not demonstrate the production of enterotoxins or toxic shock syndrome toxin 1 (TSST-1) by the isolated strain, but genetic analysis detected Panton-Valentine leukocidine gene from the strain. Subsequent empyema with bilateral pneumothorax was prolonged because of superinfection with both methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa. Optional surgical treatments, including thoracostomy and thoracopneumoplasty, finally improved his condition.
Miyashita
Taku
T
Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan. taku@med.teikyo-u.ac.jp
Shimamoto
Yuko
Y
Nishiya
Hajime
H
Koshibu
Yoji
Y
Sugiyama
Hajime
H
Ono
Yasuo
Y
Satoh
Takayoshi
T
Haraoka
Hitomi
H
Nakano
Junichi
J
Ohta
Ken
K
Sato
Tomohide
T
Morinaga
Naoko
N
Noda
Masatoshi
M
D000293:Adolescent; D016470:Bacteremia / Q000150:complications*; D001427:Bacterial Toxins; D017714:Community-Acquired Infections / Q000150:complications*; D004768:Enterotoxins / Q000633:toxicity; D005098:Exotoxins; D006801:Humans; D007956:Leukocidins / Q000096:biosynthesis / Q000235:genetics; D008297:Male; D011655:Pulmonary Embolism / Q000209:etiology*; D013203:Staphylococcal Infections / Q000150:complications*; D013211:Staphylococcus aureus; D018089:Superantigens
D001427:Bacterial Toxins; D004768:Enterotoxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal