Wang Jun, Yang Lin-hong, Wang Min, Ye Xiu-xiang, Wen Tao, Gao Jing
Second Affiliated Hospital of Shandong University of Chinese Traditional Medicine, Jinan 250001, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2007 Nov;30(11):844-7.
To improve the understanding of the clinical manifestations of complications caused by methacillin resistant Staphylococcus aureus (MRSA) pneumonia.
A case of MRSA pneumonia complicated by septicemia, multiple aneurysms and arterial thrombosis was reported, and the literature was reviewed. The pathogenesis of MRSA septicemia, aneurysm and arterial thrombosis was discussed.
A 66 year old male was admitted to this hospital because of fever, cough and sputum production for 1 month. The temperature on admission was 40 degrees C. Blood cultures for 2 times and sputum cultures all grew MRSA. The diagnosis of community acquired MRSA pneumonia and septicemia was made. The temperature returned normal after intravenous vancomycin therapy. But localized fever, pain and pulsating masses were noted, and ultrasonography and CT scanning revealed aneurysm formation in the external iliac arteries and the bilateral superior gluteal arteries, and arterial thrombi in the bilateral femoral arteries and deep femoral arteries.
MRSA pneumonia complicated with multiple aneurysm and arterial thrombosis is uncommon. Endothelial injury caused by arteritis may lead to blood coagulation, and vascular muscle injury can cause or aggravate arterial dilatation and aneurysm.
提高对耐甲氧西林金黄色葡萄球菌（MRSA）肺炎并发症临床表现的认识。
报告1例MRSA肺炎合并败血症、多发动脉瘤及动脉血栓形成的病例，并进行文献复习。探讨MRSA败血症、动脉瘤及动脉血栓形成的发病机制。
1例66岁男性因发热、咳嗽、咳痰1个月入院。入院体温40℃。2次血培养及痰培养均生长出MRSA。诊断为社区获得性MRSA肺炎并败血症。静脉滴注万古霉素治疗后体温恢复正常。但出现局部发热、疼痛及搏动性肿块，超声及CT检查显示双侧髂外动脉及双侧臀上动脉形成动脉瘤，双侧股动脉及股深动脉有动脉血栓形成。
MRSA肺炎合并多发动脉瘤及动脉血栓形成较为少见。动脉炎所致的内皮损伤可导致血液凝固，血管肌肉损伤可引起或加重动脉扩张及动脉瘤形成。
