Lavoue S, Le Gac G, Gacouin A, Revest M, Sohier L, Mouline J, Jouneau S, Flecher E, Tattevin P, Tadié J-M
Service des maladies infectieuses et réanimation médicale, CHU de Rennes, hôpital Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.
Service des maladies infectieuses et réanimation médicale, CHU de Rennes, hôpital Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France; Inserm-CIC-1414, faculté de médecine, université Rennes I, IFRI 40, 35033 Rennes, France.
Med Mal Infect. 2016 Sep;46(6):314-7. doi: 10.1016/j.medmal.2016.04.004. Epub 2016 Jul 7.
To describe two cases of Panton-Valentine leukocidin-producing Staphylococcus aureus (PVL-SA) necrotizing pneumonia treated with ECMO, and complete pulmonary evaluation at six months.
Retrospective analysis of two patients presenting with severe PVL-SA pneumonia who both underwent complete respiratory function testing and chest CT scan six months after hospital discharge.
Indications for ECMO were refractory hypoxia and left ventricular dysfunction associated with right ventricular dilatation. Patients were weaned off ECMO after 52 and 5 days. No ECMO-related hemorrhagic complication was observed. Pulmonary function tests performed at six months were normal and the CT scan showed complete regression of pulmonary injuries.
PVL-SA pneumonia is characterized by extensive parenchymal injuries, including necrotic and hemorrhagic complications. ECMO may be used as a salvage treatment without any associated hemorrhagic complication, provided anticoagulant therapy is carefully monitored, and may lead to complete pulmonary recovery at six months.
描述两例接受体外膜肺氧合（ECMO）治疗的产杀白细胞素金黄色葡萄球菌（PVL - SA）坏死性肺炎病例，并在六个月时进行全面的肺部评估。
回顾性分析两名患有严重PVL - SA肺炎的患者，他们在出院六个月后均接受了完整的呼吸功能测试和胸部CT扫描。
ECMO的指征为顽固性低氧血症以及与右心室扩张相关的左心室功能障碍。患者分别在52天和5天后脱离ECMO。未观察到与ECMO相关的出血并发症。六个月时进行的肺功能测试正常，CT扫描显示肺部损伤完全消退。
PVL - SA肺炎的特征是广泛的实质损伤，包括坏死和出血并发症。如果仔细监测抗凝治疗，ECMO可作为一种挽救性治疗方法，且无任何相关出血并发症，并且可能在六个月时实现肺部完全恢复。
