Goundan Poorani Nallam, Mehrotra Anurag, Mani Deepa, Varadarajan Indumathy
Department of General Medicine, Sri Ramachandra University, Chennai, India.
Cases J. 2010 Feb 14;3:61. doi: 10.1186/1757-1626-3-61.
Community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA) is considered an underreported entity in India. In this case report, the authors describe a thirty-five year old immunocompetent male presenting with severe respiratory distress requiring intubation. On further work up, a CT thorax showed features consistent with necrotizing pneumonia. The morphology and sensitivity pattern of the organism found in the bronchoalveolar lavage fluid and blood culture were consistent with MRSA. The patient's stay in the hospital was complicated by acute renal failure due to rhabdomyolysis with CPK levels of 9995 U/L. The patient was started on dialysis and improved there after. This case brings to light that CA-MRSA is becoming a problem in developing nations where antibiotics are frequently used empirically with little laboratory guidance. It also is a rare reporting of rhabdomyolysis due to CA-MRSA.
社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)在印度被认为是一种报告不足的病原体。在本病例报告中,作者描述了一名35岁免疫功能正常的男性,因严重呼吸窘迫需要插管治疗。进一步检查发现,胸部CT显示符合坏死性肺炎的特征。支气管肺泡灌洗液和血培养中发现的病原体的形态和药敏模式与耐甲氧西林金黄色葡萄球菌一致。患者住院期间因横纹肌溶解导致急性肾衰竭,肌酸磷酸激酶水平达9995 U/L,病情较为复杂。患者开始接受透析治疗,此后病情有所改善。该病例揭示了在发展中国家,CA-MRSA正成为一个问题,因为在这些国家,抗生素常常在缺乏实验室指导的情况下凭经验使用。此外,这也是因CA-MRSA导致横纹肌溶解的罕见病例报告。