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Fatal abscessing pneumonia caused by oxacillin-resistant Staphylococcus aureus producing Panton-Valentine leukocidin


Authors: P. Petráš 1;  M. Rumlerová 2;  I. Machová 1;  P. Nekvinda 3;  P. Beroušková 4
Authors‘ workplace: NRL pro stafylokoky SZÚ–CEM, Praha Vedoucí: RNDr. Petr Petráš, CSc. 1;  Laboratoř lékařské mikrobiologie, ZÚ se sídlem v Kolíně pracoviště Kladno Vedoucí: RNDr. Karel Rébl 2;  Anesteziologicko-resuscitační oddělení Primář: MUDr. Kamil Kodras 3;  Oddělení patologické anatomie Primář: MUDr. Milan Janoušek Oblastní nemocnice Kladno Ředitel: MUDr. Otakar Mareš 4
Published in: Prakt. Lék. 2008; 88(4): 236-239
Category: Case Report

Overview

Toxinogenic strains of Staphylococcus aureus are implicated in a wide range of severe infections. Apart from toxic shock syndrome and toxic dermatitis (pemphigus neonatorum and staphylococcal scalded skin syndrome), infections caused by staphylococci producing Panton-Valentine leukocidin (PVL) have recently become a concern. These infections affect primarily the skin and subcutaneous tissue, often with a long clinical course and final necrosis. An even greater threat is posed by rapidly progressive hemorrhagic necrotizing pneumonia reported also in young immunocompetent persons. Necrotizing pneumonia is associated with high death rates. Here we report a case of fatal abscessing pneumonia in a healthy 22-year-old male. It was caused by a community oxacillin-resistant strain of Staphylococcus aureus producing Panton–Valentine leukocidin. The infection had a rapidly fatal outcome: the patient died within 6 days, i.e. 2 days after admission to hospital. As far as we know, such a case has not yet been reported in the Czech literature.

Key words:
Toxinogenic S. aureus, MRSA, Panton-Valentine leukocidin, abscessing pneumonia.


Sources

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7. Machová, I., Petráš, P., Blažková, E., Kňapová, L. Sledování genů kódujících Pantonův-Valentinův leukocidin u kmenů Staphylococcus aureus. Epidemiol. Mikrobiol. Imunol. 2007, 56, č.2, s. 88-93.

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9. Health Protection Agency PVL Working Group, Department of Health, UK:

Interim guidance on diagnosis and management of PVL–associated Staphylococcal infections in the UK [on line]. 2007-03-13 [cit. 2008-04-11]. Dostupný na WWW:

http://www.dh.gov.uk/en/Aboutus/MinistersandDepartmentLeaders/ChiefMedicalOfficer/Features/DH_4133761

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