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Necrotizing pneumonia and septic shock: suspecting CA-MRSA in patients presenting to Canadian emergency departments

Published online by Cambridge University Press:  21 May 2015

Joseph V. Vayalumkal ,
Heather Whittingham ,
Otto Vanderkooi ,
Thomas E. Stewart ,
Donald E. Low ,
Michael Mulvey  and
Allison McGeer
Joseph V. Vayalumkal
Affiliation:
Department of Pediatrics, Division of Infectious Diseases, Alberta Children's Hospital, University of Calgary, Calgary, Alta.
Heather Whittingham
Affiliation:
Department of Medicine, University of Toronto, Toronto, Ont.
Otto Vanderkooi
Affiliation:
Departments of Microbiology, University of Toronto, Toronto, Ont.
Thomas E. Stewart
Affiliation:
Interdepartmental Division of Critical Care, Mount Sinai Hospital, University of Toronto, Toronto, Ont.
Donald E. Low
Affiliation:
Departments of Microbiology, University of Toronto, Toronto, Ont.
Michael Mulvey
Affiliation:
National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Man.
Allison McGeer*
Affiliation:
Departments of Microbiology, University of Toronto, Toronto, Ont.
*
Department of Microbiology, Mount Sinai Hospital, Rm. 210, 600 University Ave., Toronto ON M5G 1X5; amcgeer@mtsinai.on.ca

Abstract

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We report a case of fatal necrotizing pneumonia and sepsis caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in an otherwise well, 48-year-old Canadian man with type 2 diabetes mellitus who had travelled to Texas. Despite therapy that included intravenous antibiotics, intravenous immune globulin and other supportive measures, the patient succumbed to his illness. Recently, CA-MRSA pneumonia has been reported in several countries. The virulence of this organism may in part be related to its ability to produce toxins, such as Panton-Valentine leukocidin. As rates of CA-MRSA increase worldwide, physicians should be aware of the potential for MRSA to cause life-threatening infections in patients presenting to Canadian emergency departments (EDs). Necrotizing pneumonia caused by MRSA must be considered in the differential diagnosis of acute, severe respiratory illness. Early recognition of this syndrome in the ED may help physicians initiate appropriate antibiotic therapy in a timely manner.

Keywords

necrotizing pneumoniaMRSAcommunity-acquired MRSACanada
Type
Case Report • Observation de cas
Information
Canadian Journal of Emergency Medicine , Volume 9 , Issue 4 , July 2007 , pp. 300 - 303
Copyright
Copyright © Canadian Association of Emergency Physicians 2007

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