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Case Reports
. 2024 Apr 18:49:102023.
doi: 10.1016/j.rmcr.2024.102023. eCollection 2024.

A case of community-acquired Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus (MRSA) necrotizing pneumonia successfully treated with two anti-MRSA drugs

Ritsuya Shiiba  1 , Masahiro Sano  1 , Yoshihito Kogure  1 , Hiroto Murao  1 , Yuki Takigawa  1 , Atsushi Torii  1 , Arisa Yamada  1 , Yuka Shinohara  1 , Hideyuki Niwa  1 , Chiyoe Kitagawa  1 , Masahide Oki  1
Affiliations
Case Reports

A case of community-acquired Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus (MRSA) necrotizing pneumonia successfully treated with two anti-MRSA drugs

Ritsuya Shiiba et al. Respir Med Case Rep. .

Abstract

A 22-year-old Vietnamese man was referred to our hospital owing to cough, dyspnea, and difficulty moving. The patient was diagnosed with community-acquired Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and necrotizing pneumonia. Treatment involved vancomycin (VCM) and meropenem, and the MRSA bacteremia improved. However, lung tissue destruction progressed. Therefore, linezolid was added to the VCM regimen, and this intervention led to the patient's recovery, and he was discharged from the hospital. Here, we report a case in which the patient was treated with a combination of two anti-MRSA drugs and was cured.

Keywords: Linezolid; Methicillin-resistant Staphylococcus aureus (MRSA); Necrotizing pneumonia; Panton-Valentine leukocidin (PVL); Vancomycin.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Chest radiograph on admission after intubation shows consolidation in the bilateral lower lung and hollow shadow in the right lower lung.
Fig. 2
Fig. 2
Computed tomography on admission. Extensive infiltration shadows and frosted shadows mainly in the bilateral lower lobes (a). A cyst formation in the right lower lobe. There is no fluid retention within the cyst or right pleural effusion, but a small amount of left pleural effusion is noted (b).
Fig. 3
Fig. 3
Chest radiograph, after drainage of the right lung cyst and thoracic cavity on day 8. Infiltrating shadows extend to the right middle and lower lung fields and the left whole lung field. The left lung field shows the appearance of a cavity shadow.
Fig. 4
Fig. 4
Computed tomography, which after drainage of the right lung cyst and thoracic cavity on day 8. An infiltrative shadow is seen in the right lower lobe. The left upper lobe also shows an infiltrative shadow (a). Abscesses are seen in the right anterior thoracic region and left lateral thoracic region (b).
Fig. 5
Fig. 5
Chest radiograph at discharge shows a linear shadow in the right middle lung field and a partial frosted shadow in the left lung, but the infiltration and cavity shadows have improved.
Fig. 6
Fig. 6
Antimicrobial treatment course and drainage treatment course in this case.
See this image and copyright information in PMC

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References

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