[Fatal pneumonia in an adolescent due to community-acquired methicillin-resistant Staphylococcus aureus positive for Panton-Valentine-leukocidin]

Ned Tijdschr Geneeskd. 2003 May 31;147(22):1076-9.
[Article in Dutch]

Abstract

A 15-year-old girl developed a severe Staphylococcus aureus pneumonia following an influenza virus infection. The patient was admitted to a paediatric intensive-care facility because of respiratory and circulatory failure. Despite aggressive therapy, she died on the third day following admission to the intensive care unit due to secondary hypoxic-ischaemic encephalopathy. Blood and respiratory aspirate cultures showed community-acquired methicillin-resistant S. aureus (CA-MRSA) with a normal antibiotic sensitivity except for betalactam antibiotics. PCR-based methods demonstrated that the isolate possessed the Panton-Valentine-leukocidin (PVL) gene, encoding an S. aureus exotoxin that is associated with fulminant necrotising pneumonia. This case shows that clinicians in the Netherlands should also be aware of the possibility of CA-MRSA in patients without risk factors for MRSA carriage. Especially in children and adolescents with an influenza virus infection, pneumonia due to PVL-positive S. aureus strains may be life-threatening.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adolescent
  • Bacterial Toxins
  • Community-Acquired Infections / microbiology
  • Community-Acquired Infections / mortality
  • Community-Acquired Infections / pathology
  • Exotoxins
  • Fatal Outcome
  • Female
  • Humans
  • Leukocidins / genetics*
  • Leukocidins / metabolism
  • Methicillin Resistance*
  • Pneumonia, Staphylococcal / microbiology*
  • Pneumonia, Staphylococcal / mortality
  • Pneumonia, Staphylococcal / pathology
  • Staphylococcal Infections / microbiology*
  • Staphylococcal Infections / mortality
  • Staphylococcal Infections / pathology
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / genetics*
  • Staphylococcus aureus / pathogenicity

Substances

  • Bacterial Toxins
  • Exotoxins
  • Leukocidins
  • Panton-Valentine leukocidin