Vayalumkal Joseph V, Whittingham Heather, Vanderkooi Otto, Stewart Thomas E, Low Donald E, Mulvey Michael, McGeer Allison
Department of Pediatrics, Division of Infectious Diseases, Alberta Children's Hospital, University of Calgary, Calgary, Alberta.
CJEM. 2007 Jul;9(4):300-3. doi: 10.1017/s1481803500015219.
We report a case of fatal necrotizing pneumonia and sepsis caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in an otherwise well, 48-year-old Canadian man with type 2 diabetes mellitus who had travelled to Texas. Despite therapy that included intravenous antibiotics, intravenous immune globulin and other supportive measures, the patient succumbed to his illness. Recently, CA-MRSA pneumonia has been reported in several countries. The virulence of this organism may in part be related to its ability to produce toxins, such as Panton-Valentine leukocidin. As rates of CA-MRSA increase worldwide, physicians should be aware of the potential for MRSA to cause life-threatening infections in patients presenting to Canadian emergency departments (EDs). Necrotizing pneumonia caused by MRSA must be considered in the differential diagnosis of acute, severe respiratory illness. Early recognition of this syndrome in the ED may help physicians initiate appropriate antibiotic therapy in a timely manner.
我们报告了一例由社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）引起的致命性坏死性肺炎和败血症病例，患者是一名48岁的加拿大男子，患有2型糖尿病，身体健康，曾前往德克萨斯州。尽管接受了包括静脉注射抗生素、静脉注射免疫球蛋白和其他支持措施在内的治疗，患者仍因病死亡。最近，几个国家都报告了CA-MRSA肺炎病例。这种病原体的毒力可能部分与其产生毒素（如杀白细胞素）的能力有关。随着全球CA-MRSA感染率的上升，医生应意识到耐甲氧西林金黄色葡萄球菌在前往加拿大急诊科（ED）就诊的患者中引发危及生命感染的可能性。在急性重症呼吸道疾病的鉴别诊断中，必须考虑由耐甲氧西林金黄色葡萄球菌引起的坏死性肺炎。在急诊科早期识别这种综合征可能有助于医生及时启动适当的抗生素治疗。
