Document Detail


Fatal community-associated methicillin-resistant Staphylococcus aureus pneumonia in an immunocompetent young adult.
MedLine Citation:
PMID:  16271665     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Severe pneumonia caused by community-associated methicillin-resistant Staphylococcus aureus (MRSA) was reported in children soon after this pathogen emerged in the United States in the 1990s. Genes for Panton Valentine leukocidin, which are present in the majority of community-associated MRSA, are thought to enhance the ability of S aureus to cause necrotizing pneumonia. Despite the rapid spread throughout the United States of community-associated MRSA and related skin and soft-tissue infections, reports of severe pneumonia in adults have been rare. We describe a case of a healthy young adult who initially was treated as an outpatient with levofloxacin for what appeared to be typical community-acquired pneumonia. He soon returned to the emergency department (ED) with rapidly fatal necrotizing pneumonia, associated with hemoptysis, leukopenia, and sepsis syndrome, that was caused by community-associated MRSA carrying genes for Panton Valentine leukocidin. This case highlights the typical features of this form of pneumonia and the need to consider MRSA when evaluating and treating severe pneumonia in the ED. It also raises the question of whether the incidence of this form of pneumonia might be increasing in communities with a high prevalence of community-associated MRSA and whether current pneumonia treatment guidelines should be modified.
Authors:
Bradley W Frazee; Toby O Salz; Larry Lambert; Francoise Perdreau-Remington
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2005-08-01
Journal Detail:
Title:  Annals of emergency medicine     Volume:  46     ISSN:  1097-6760     ISO Abbreviation:  Ann Emerg Med     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-07     Completed Date:  2006-01-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  401-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Emergency Medicine, Alameda County Medical Center-Highland Campus, Oakland, CA 94602, USA. bfrazee@hghed.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Community-Acquired Infections / diagnosis,  drug therapy,  immunology,  microbiology
Diagnosis, Differential
Fatal Outcome
Humans
Immunocompetence
Male
Methicillin Resistance*
Pneumonia, Pneumococcal / diagnosis
Pneumonia, Staphylococcal / diagnosis*,  drug therapy*,  immunology,  microbiology
Staphylococcus aureus / isolation & purification

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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