Necrotizing pneumonia and septic shock: suspecting CA-MRSA in patients presenting to Canadian emergency departments.
We report a case of fatal necrotizing pneumonia and sepsis caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in an otherwise well, 48-year-old Canadian man with type 2 diabetes mellitus who had travelled to Texas. Despite therapy that included intravenous antibiotics, intravenous immune globulin and other supportive measures, the patient succumbed to his illness. Recently, CA-MRSA pneumonia has been reported in several countries. The virulence of this organism may in part be related to its ability to produce toxins, such as Panton-Valentine leukocidin. As rates of CA-MRSA increase worldwide, physicians should be aware of the potential for MRSA to cause life-threatening infections in patients presenting to Canadian emergency departments (EDs). Necrotizing pneumonia caused by MRSA must be considered in the differential diagnosis of acute, severe respiratory illness. Early recognition of this syndrome in the ED may help physicians initiate appropriate antibiotic therapy in a timely manner.
Vayalumkal
Joseph V
JV
Department of Pediatrics, Division of Infectious Diseases, Alberta Children's Hospital, University of Calgary, Calgary, Alberta.
Whittingham
Heather
H
Vanderkooi
Otto
O
Stewart
Thomas E
TE
Low
Donald E
DE
Mulvey
Michael
M
McGeer
Allison
A
D001427:Bacterial Toxins; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000382:microbiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003937:Diagnosis, Differential; D005098:Exotoxins; D017809:Fatal Outcome; D006801:Humans; D007956:Leukocidins; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D009336:Necrosis; D011023:Pneumonia, Staphylococcal / Q000175:diagnosis* / Q000382:microbiology; D012772:Shock, Septic / Q000382:microbiology*; D014195:Travel
D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin