title: Extracorporeal circuit for Panton-Valentine leukocidin-producing Staphylococcus aureus necrotizing pneumonia.
abstract: OBJECTIVE
  To describe two cases of Panton-Valentine leukocidin-producing Staphylococcus aureus (PVL-SA) necrotizing pneumonia treated with ECMO, and complete pulmonary evaluation at six months.
  
  
  METHODS
  Retrospective analysis of two patients presenting with severe PVL-SA pneumonia who both underwent complete respiratory function testing and chest CT scan six months after hospital discharge.
  
  
  RESULTS
  Indications for ECMO were refractory hypoxia and left ventricular dysfunction associated with right ventricular dilatation. Patients were weaned off ECMO after 52 and 5 days. No ECMO-related hemorrhagic complication was observed. Pulmonary function tests performed at six months were normal and the CT scan showed complete regression of pulmonary injuries.
  
  
  CONCLUSIONS
  PVL-SA pneumonia is characterized by extensive parenchymal injuries, including necrotic and hemorrhagic complications. ECMO may be used as a salvage treatment without any associated hemorrhagic complication, provided anticoagulant therapy is carefully monitored, and may lead to complete pulmonary recovery at six months.
authors.affiliation: Service des maladies infectieuses et réanimation médicale, CHU de Rennes, hôpital Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.
authors.forename: S
authors.initials: S
authors.lastname: Lavoue
authors.affiliation: Service des maladies infectieuses et réanimation médicale, CHU de Rennes, hôpital Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.
authors.forename: G
authors.initials: G
authors.lastname: Le Gac
authors.affiliation: Service des maladies infectieuses et réanimation médicale, CHU de Rennes, hôpital Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France; Inserm-CIC-1414, faculté de médecine, université Rennes I, IFRI 40, 35033 Rennes, France.
authors.forename: A
authors.initials: A
authors.lastname: Gacouin
authors.affiliation: Service des maladies infectieuses et réanimation médicale, CHU de Rennes, hôpital Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France; Inserm-CIC-1414, faculté de médecine, université Rennes I, IFRI 40, 35033 Rennes, France.
authors.forename: M
authors.initials: M
authors.lastname: Revest
authors.affiliation: Service de pneumologie, centre hospitalier Lorient, 56322 Lorient, France.
authors.forename: L
authors.initials: L
authors.lastname: Sohier
authors.affiliation: Service de réanimation, centre hospitalier Lorient, 56322 Lorient, France.
authors.forename: J
authors.initials: J
authors.lastname: Mouline
authors.affiliation: Service de pneumologie, CHU de Rennes, hôpital Pontchaillou, 35033 Rennes, France.
authors.forename: S
authors.initials: S
authors.lastname: Jouneau
authors.affiliation: Département de chirurgie thoracique et cardiovasculaire, CHU de Rennes, hôpital Pontchaillou, 35033 Rennes, France.
authors.forename: E
authors.initials: E
authors.lastname: Flecher
authors.affiliation: Service des maladies infectieuses et réanimation médicale, CHU de Rennes, hôpital Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France; Inserm-CIC-1414, faculté de médecine, université Rennes I, IFRI 40, 35033 Rennes, France.
authors.forename: P
authors.initials: P
authors.lastname: Tattevin
authors.affiliation: Service des maladies infectieuses et réanimation médicale, CHU de Rennes, hôpital Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France; Inserm-CIC-1414, faculté de médecine, université Rennes I, IFRI 40, 35033 Rennes, France. Electronic address: jean-marc.tadie@chu-rennes.fr.
authors.forename: J-M
authors.initials: JM
authors.lastname: Tadié
mesh_terms: D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D001427:Bacterial Toxins / Q000032:analysis*; D005098:Exotoxins / Q000032:analysis*; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000139:chemically induced / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007956:Leukocidins / Q000032:analysis*; D008168:Lung / Q000000981:diagnostic imaging; D008171:Lung Diseases / Q000139:chemically induced / Q000209:etiology / Q000517:prevention & control; D055624:Methicillin-Resistant Staphylococcus aureus / Q000737:chemistry / Q000302:isolation & purification; D000071067:Pneumonia, Necrotizing / Q000150:complications / Q000000981:diagnostic imaging / Q000382:microbiology / Q000628:therapy*; D011023:Pneumonia, Staphylococcal / Q000150:complications / Q000000981:diagnostic imaging / Q000382:microbiology / Q000628:therapy*; D012074:Remission Induction; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D016879:Salvage Therapy; D013211:Staphylococcus aureus / Q000737:chemistry* / Q000302:isolation & purification; D014057:Tomography, X-Ray Computed; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D014662:Vasoconstrictor Agents
keywords: Acute respiratory distress syndrome; ECMO; Panton-Valentine leukocidin-producing Staphylococcus aureus; Pneumopathie à Staphylococcus aureus; Staphylococcal pneumonia; Staphylococcus aureus producteur de la leucocidine de Panton-Valentine; Syndrome de détresse respiratoire aiguë