Piracha Shahbaz, Ahmed Syeda Saba Muneer, Mohd Afzal Samira, Ganaie Muhammad Badar
Department of Respiratory Medicine, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK.
Department of Infectious Diseases, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK.
BMJ Case Rep. 2019 Apr 3;12(4):e228297. doi: 10.1136/bcr-2018-228297.
We report a case of a previously fit middle-aged man presenting to the outpatient setting with unilateral pleural effusion, with minimal symptoms. On subsequent investigations, he was diagnosed with empyema thoracis secondary to Panton-Valentine leukocidin (PVL)-toxin positive community-acquired methicillin-resistant (MRSA). The patient was treated with prolonged antibiotics and pleural drainage, and he remained haemodynamically stable throughout hospital admission. PVL is a cytolytic exotoxin produced by some strains of Such strains often cause recurrent skin and soft tissue infections, usually in previously fit and healthy individuals. Less commonly, invasive infections occur; these carry a high mortality rate if associated with necrotising pneumonia or septic shock. PVL genes are present in approximately 2% of clinical isolates of in the UK. PVL-producing MRSA infections are on the rise and present significant clinical and public health challenges.
我们报告一例病例，一名既往健康的中年男性因单侧胸腔积液就诊于门诊，症状轻微。后续检查发现，他被诊断为继发于杀白细胞素（PVL）毒素阳性的社区获得性耐甲氧西林金黄色葡萄球菌（MRSA）的脓胸。患者接受了长时间的抗生素治疗和胸腔引流，住院期间血流动力学一直保持稳定。PVL是某些金黄色葡萄球菌菌株产生的一种溶细胞外毒素。这类菌株常引起复发性皮肤和软组织感染，通常发生在既往健康的个体中。较少见的情况下会发生侵袭性感染；如果与坏死性肺炎或感染性休克相关，这些感染的死亡率很高。在英国，约2%的临床分离金黄色葡萄球菌菌株中存在PVL基因。产PVL的MRSA感染呈上升趋势，带来了重大的临床和公共卫生挑战。
