title: Community acquired pneumonia with shock, severe hypoxemia and leucopenia: Is the etiology methicillin resistant Staphylococci?
abstract: A young, male presented to the emergency department with respiratory signs and symptoms along with shock and leucopenia. The suspected diagnosis of methicillin resistant Staphylococcus aureus (MRSA) necrotizing pneumonia was confirmed later radiographically and microbiologically. This entity is common in childhood, but rarely reported in adults. This form of pneumonia affects young individuals without any comorbid illness. This is the first reported case of necrotizing pneumonia caused by community acquired-MRSA from Indian subcontinent. The probability to predict etiology of pneumonia from clinical signs is low; yet in the presence of shock, severe hypoxemia and leucopenia suspicion of MRSA should be kept high and hence that prompt initiation of appropriate antimicrobials may reduce mortality.
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Garima
authors.initials: G
authors.lastname: Kapoor
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Saigal
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Jai Prakash
authors.initials: JP
authors.lastname: Sharma
authors.affiliation: Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Mohan
authors.initials: M
authors.lastname: Gurjar
keywords: Leucopenia; methicillin resistant Staphylococcus aureus; necrotizing pneumonia