Catena Vincenzo, Baiocchi Marco, Lentini Paolo, Badolati Luigi, Baccarin Monica, Del Monte Daniele D, Rubini Alessandro
Dipartimento di Emergenza e Terapia Intensiva, U.L.S.S. 2, Feltre, Belluno, Italy.
Infez Med. 2012 Sep;20(3):205-10.
Staphylococcus aureus harboured by Panton-Valentine leukocidin (PVL) is emerging as a serious problem worldwide. There has been an increase in the incidence of necrotizing lung infections in otherwise healthy young people with very high mortality rate associated with these strains. This report documents a confirmed case of necrotizing pneumonia due to methicillin-susceptible S. aureus (MSSA) harbouring Panton-Valentine leukocidin genes. An apparently healthy 49-year old man was admitted to our hospital for dyspnea and he quickly developed acute respiratory distress syndrome. MSSA harbouring Panton-Valentine leukocidin genes were cultured from the abscess fluid and from multiple blood specimens. Aggressive antibiotic therapy was started and intensive supportive care led finally to a complete recovery. Rapid identification of Panton-Valentine leukocidin in MSSA samples should be supposed when a young, immunocompetent patient, develops a necrotizing pneumonia. Bactericidal antistaphylococcal antibiotics are recommended for the treatment as soon as possible to avoid the potentially devastating consequences of this kind of S. aureus.
携带杀白细胞素(PVL)的金黄色葡萄球菌正在成为全球范围内的一个严重问题。在原本健康的年轻人中,坏死性肺部感染的发病率有所上升,且与这些菌株相关的死亡率非常高。本报告记录了一例由携带杀白细胞素基因的甲氧西林敏感金黄色葡萄球菌(MSSA)引起的坏死性肺炎确诊病例。一名看似健康的49岁男性因呼吸困难入院,随后迅速发展为急性呼吸窘迫综合征。从脓肿液和多份血液标本中培养出了携带杀白细胞素基因的MSSA。开始了积极的抗生素治疗,并进行了强化支持治疗,最终患者完全康复。当一名年轻、免疫功能正常的患者发生坏死性肺炎时,应考虑快速鉴定MSSA样本中的杀白细胞素。建议尽快使用杀菌性抗葡萄球菌抗生素进行治疗,以避免这种金黄色葡萄球菌可能带来的毁灭性后果。