Successful treatment of pleural empyema and necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus infection following influenza A virus infection: A case report and literature review

Abstract

With the rapid increase in the number of infections, children with Staphylococcus aureus (S. aureus) infection secondary to Influenza A virus (IAV), appear to have a great possibility of causing severe complications and illness. Despite some cases and research findings regarding the death of children with IAV and S. aureus, coinfection included, there were few details about successful treatment of pleural empyema and necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA) infection following IAV. In this case report, we describe the clinical symptoms and treatment of a teenager with pleural empyema and necrotizing pneumonia related to S. aureus secondary infection who was initially infected by IAV. This case highlights the importance of early recognition and application of thoracoscopy for this potentially fatal pleural empyema caused by MRSA and IAV coinfection. We conclude that this is a significant case that contributes to raising awareness regarding rarely occurring severe respiratory infections by MRSA in a child with normal immune function after IAV. In addition, further studies are needed to explore risk factors for IAV coinfection with S. aureus.

Necrotizing Pneumonia in Children: Early Recognition and Management

“…In recent years, severe pediatric CAP caused by bacterial (pneumococcus, Staphylococcus aureus , Pseudomonas aeruginosa ) or viral (adenovirus, rhinovirus, respiratory syncytial virus, parainfluenza virus, coronavirus, influenza virus, enterovirus, among others, respectively) coinfection with Mycoplasma pneumoniae has been increasingly reported [ 71 , 72 , 73 ]. NP associated with influenza virus or parainfluenza virus infections prior to pneumococcus or Staphylococcus aureus infections has been long reported [ 47 , 74 , 75 , 76 , 77 , 78 ]. Children co-infected with influenza A and Staphylococcus aureus are more likely to cause severe complications rapidly and have a higher mortality rate partly because of the difficulty of getting accurate and timely treatment [ 76 ].…”

“…NP associated with influenza virus or parainfluenza virus infections prior to pneumococcus or Staphylococcus aureus infections has been long reported [ 47 , 74 , 75 , 76 , 77 , 78 ]. Children co-infected with influenza A and Staphylococcus aureus are more likely to cause severe complications rapidly and have a higher mortality rate partly because of the difficulty of getting accurate and timely treatment [ 76 ].…”

“…It can detect endobronchial abnormalities, obtain more efficient samples for bacteriologic, cytologic and histologic detection and offer therapeutic interventions [ 134 ]. Taking the opportunity to apply bronchoscopy has been shown to promote rapid recovery in refractory pneumonia, while bronchoscopy for NP has been rarely reported [ 76 , 133 , 135 ]. Chest drains, a kind of interventional procedure, are used to remove large empyema or parapneumonic effusion or pyopneumothorax in children with NP.…”