Panton–Valentine leukocidin-associated Staphylococcus aureus necrotizing pneumonia in infants: a report of four cases and review of the literature

Schwartz, Kevin L; Nourse, Clare

doi:10.1007/s00431-011-1651-y

Cited by 30 publications

(24 citation statements)

References 35 publications

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“…1,2,7 Pulmonary manifestations of MRSA have been described previuosly 2,8 and usually include empyema or lung abscess, but more often multiple, thin-walled, air-filled, cystlike foci, often referred to as pneumatoceles, which are seen as sequelae from acute pneumonia due to MRSA. 1,2,4,6,9 Although the mean age of S. aureus pneumonia is typically approximately 9 months 1,2,8 (range, 3.5 mo to 4 y), this infection is increasingly being seen in younger age groups.…”

Section: Discussionmentioning

confidence: 98%

“…20 The role of intravenous immunoglobulin (IVIG) in the treatment of S. aureus pneumonia is still not established, 1,17 although in vitro studies have shown that immunoglobulins neutralize the effect of PVL on polymorphonuclear neutrophils. 21 Given this beneficial effect, current United Kingdom guidelines recommend the use of IVIG for severe disease.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of MRSA pneumonia in children has increased in the last few years, in both community and hospital settings. [1][2][3][4] The severity of the disease may be attributed to Panton-Valentine leukocidinsecreting S. aureus (PVL + SA). 1,2,4 Early and prompt treatment with both bactericidal and antitoxic agents is crucial for invasive disease.…”

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confidence: 99%

“…1,2,4 Early and prompt treatment with both bactericidal and antitoxic agents is crucial for invasive disease. 1,2,4,5 We describe the case of a previously healthy 6-week-old infant who developed severe necrotizing pneumonia and presented with multiple pulmonary pneumatoceles due to PVL + SA.…”

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confidence: 99%

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Multiple Pneumatoceles in a 6-Week-Old Infant

Venkataraman

Sadasivam

2016

Clinical Pulmonary Medicine

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Methicillin-resistant Staphylococcus aureus (MRSA) usually causes skin and soft tissue infections in children and is occasionally associated with hospital-acquired pneumonias, but in recent years, there has been an increase in the incidence of communityacquired MRSA pneumonia. We report a case of community-acquired Panton-Valentine leukocidin secreting MRSA necrotizing pneumonia in a previously well 6-week-old infant, who presented with multiple pneumatoceles. This case highlights the possibility of emerging community-acquired MRSA pneumonia in healthy infants.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Multiple Pneumatoceles in a 6-Week-Old Infant

Venkataraman

Sadasivam

2016

Clinical Pulmonary Medicine

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“…of cases)Pneumothorax (No. of cases)ARDSECMOHFOVProne positionSurgerySurvivalSurvival with ECMOPanchabhai, 2015 [18]1 adult110010Right lung up1 left pneumonectomy1/11/1Schwartz, 2012 [19]4 infants44342NRNR02/40/2Noah, 2010 [2]2 adults2 adolescents443441NR2 thoracotomy4/44/4Castaldo, 2007 [20]8 childrenNR7474NRNRNR4/81/4Stroud, 2007 [1]2 childrenNR21221NR02/22/2This case1 adult111111101/11/1Total20 patiens4 adults16 children/adolescents100%(10/10)95%(19/20)60%(12/20)90%(18/20)70%(14/20)37.5%(3/8)50%(1/2)25%(3/12)70%(14/20)64%(9/14) PVL Panton-Valentine leukocidin, MRSA methicillin resistant Staphylococcus aureus , ARDS acute respiratory distress syndrome, ECMO extracorporeal membrane oxygenation, HFOV high frequency oscillatory ventilation, NR not reported …”

Section: Review Of Cases From the Literaturementioning

confidence: 99%

Successful rescue combination of extracorporeal membrane oxygenation, high-frequency oscillatory ventilation and prone positioning for the management of severe methicillin-resistant Staphylococcus aureus pneumonia complicated by pneumothorax: a case report and literature review

Wang

et al. 2017

BMC Pulm Med

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BackgroundTo describe the experience of combination therapy with extracorporeal membrane oxygenation(ECMO), high-frequency oscillatory ventilation(HFOV) and prone positioning in treating severe respiratory failure caused by community acquired methicillin resistant Staphylococcus aureus(CA-MRSA).Case presentationA 30-year-old female presented with fever and dyspnea for 3 days. She was diagnosed CA-MRSA pneumonia complicated by severe respiratory failure, pneumothorax and neutropenia. Venovenous ECMO was applied within 8 h of the pneumothorax diagnosis. For amelioration of ventilator-induced lung injury, HFOV and prone positioning were combined with ECMO. The patient’s condition improved considerably. ECMO was weaned on day 19, and she was discharged on day 48 with good lung recovery.ConclusionsTo the best of our knowledge, this was the first case in which ECMO was combined with HFOV and prone positioning to treat severe necrotic CA-MRSA pneumonia complicated with pneumothorax. This combination therapy may provide safe respiratory support, may minimize the risk of barotrauma, and provide better drainage of secretions in patients with necrotizing pneumonia.

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Treatment of Staphylococcus aureus Infections

David

Daum

2017

Current Topics in Microbiology and Immunology

102

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Staphylococcus aureus, although generally identified as a commensal, is also a common cause of human bacterial infections, including of the skin and other soft tissues, bones, bloodstream, and respiratory tract. The history of S. aureus treatment is marked by the development of resistance to each new class of antistaphylococcal antimicrobial drugs, including the penicillins, sulfonamides, tetracyclines, glycopeptides, and others, complicating therapy. S. aureus isolates identified in the 1960s were sometimes resistant to methicillin, a ß-lactam antimicrobial active initially against a majority S. aureus strains. These MRSA isolates, resistant to nearly all ß-lactam antimicrobials, were first largely confined to the health care environment and the patients who attended it. However, in the mid-1990s, new strains, known as community-associated (CA-) MRSA strains, emerged. CA-MRSA organisms, compared with health care-associated (HA-) MRSA strain types, are more often susceptible to multiple classes of non ß-lactam antimicrobials. While infections caused by methicillin-susceptible S. aureus (MSSA) strains are usually treated with drugs in the ß-lactam class, such as cephalosporins, oxacillin or nafcillin, MRSA infections are treated with drugs in other antimicrobial classes. The glycopeptide drug vancomycin, and in some countries teicoplanin, is the most common drug used to treat severe MRSA infections. There are now other classes of antimicrobials available to treat staphylococcal infections, including several that have been approved after 2009. The antimicrobial management of invasive and noninvasive S. aureus infections in the ambulatory and in-patient settings is the topic of this review. Also discussed are common adverse effects of antistaphylococcal antimicrobial agents, advantages of one agent over another for specific clinical syndromes, and the use of adjunctive therapies such as surgery and intravenous immunoglobulin. We have detailed considerations in the therapy of noninvasive and invasive S. aureus infections. This is followed by sections on specific clinical infectious syndromes including skin and soft tissue infections, bacteremia, endocarditis and intravascular infections, pneumonia, osteomyelitis and vertebral discitis, epidural abscess, septic arthritis, pyomyositis, mastitis, necrotizing fasciitis, orbital infections, endophthalmitis, parotitis, staphylococcal toxinoses, urogenital infections, and central nervous system infections.

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Panton–Valentine leukocidin-associated Staphylococcus aureus necrotizing pneumonia in infants: a report of four cases and review of the literature

Cited by 30 publications

References 35 publications

Multiple Pneumatoceles in a 6-Week-Old Infant

Multiple Pneumatoceles in a 6-Week-Old Infant

Successful rescue combination of extracorporeal membrane oxygenation, high-frequency oscillatory ventilation and prone positioning for the management of severe methicillin-resistant Staphylococcus aureus pneumonia complicated by pneumothorax: a case report and literature review

Treatment of Staphylococcus aureus Infections

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