tetano
Editor, Senior Moderator
In Vivo. 2014 09-10;28(5):961-965.
Successful Treatment of Panton-Valentine Leukocidin-expressing Staphylococcus aureus-associated Pneumonia Co-infected with Influenza Using Extracorporeal Membrane Oxygenation.
Fujisaki N1, Takahashi A2, Arima T2, Mizushima T2, Ikeda K2, Kakuchi H2, Nakao A3, Kotani J4, Sakaida K2.
Author information
Abstract
Background: Panton-Valentine leukocidin (PVL) is a cytotoxin that causes leukocyte destruction and lung necrosis. Managing respiratory failure and acute respiratory distress syndrome secondary to PVL-expressing Staphylococcus aureus pneumonia and its associated lung necrosis with mechanical ventilation is challenging. We report a patient with life-threatening PVL-expressing S. aureus-associated pneumonia who was rescued using extracorporeal membrane oxygenation (ECMO). Case Report: We examined the case of a woman who presented to our Emergency Department with septic shock due to PVL-expressing S. aureus-associated pneumonia. A 27-year-old Filipino woman was transferred to our hospital due to severe dyspnea, hemosputum, and high-grade fever. She had a medical history of osteosarcoma of the leg and hyperthyroidism. On arrival, her vital signs indicated septic shock, with a white blood cell count of 3.5?103/μl. Because a Gram stain of her sputum indicated SA, therapy with antibiotics, including meropenem and vancomycin, was started. Hypoxemia necessitated intubation and ventilation. Because the patient's PaO2/FiO2 remained less than 60 mmHg and her blood pressure was unstable despite aggressive conventional management, venoarterial ECMO was administered approximately 11 h after her arrival. The ECMO circuit was changed to veno-venous ECMO on day 7 and the patient was successfully weaned off ECMO after 12 days of treatment. She was discharged from the hospital 104 days after admission. Conclusion: This case demonstrates that early induction of ECMO support can be a reasonable therapeutic option for PVL-S. aureus-associated pneumonia. This patient's successful outcome might be attributable to early establishment of ECMO to prevent ventilation-induced lung injury.
Copyright ? 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.
KEYWORDS:
PVL; Panton-Valentine leukocidin; Staphylococcus aureus; influenza; leukocyte destruction; lung necrosis; membrane oxygenation; pneumonia
PMID:
25189914
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/25189914
Successful Treatment of Panton-Valentine Leukocidin-expressing Staphylococcus aureus-associated Pneumonia Co-infected with Influenza Using Extracorporeal Membrane Oxygenation.
Fujisaki N1, Takahashi A2, Arima T2, Mizushima T2, Ikeda K2, Kakuchi H2, Nakao A3, Kotani J4, Sakaida K2.
Author information
Abstract
Background: Panton-Valentine leukocidin (PVL) is a cytotoxin that causes leukocyte destruction and lung necrosis. Managing respiratory failure and acute respiratory distress syndrome secondary to PVL-expressing Staphylococcus aureus pneumonia and its associated lung necrosis with mechanical ventilation is challenging. We report a patient with life-threatening PVL-expressing S. aureus-associated pneumonia who was rescued using extracorporeal membrane oxygenation (ECMO). Case Report: We examined the case of a woman who presented to our Emergency Department with septic shock due to PVL-expressing S. aureus-associated pneumonia. A 27-year-old Filipino woman was transferred to our hospital due to severe dyspnea, hemosputum, and high-grade fever. She had a medical history of osteosarcoma of the leg and hyperthyroidism. On arrival, her vital signs indicated septic shock, with a white blood cell count of 3.5?103/μl. Because a Gram stain of her sputum indicated SA, therapy with antibiotics, including meropenem and vancomycin, was started. Hypoxemia necessitated intubation and ventilation. Because the patient's PaO2/FiO2 remained less than 60 mmHg and her blood pressure was unstable despite aggressive conventional management, venoarterial ECMO was administered approximately 11 h after her arrival. The ECMO circuit was changed to veno-venous ECMO on day 7 and the patient was successfully weaned off ECMO after 12 days of treatment. She was discharged from the hospital 104 days after admission. Conclusion: This case demonstrates that early induction of ECMO support can be a reasonable therapeutic option for PVL-S. aureus-associated pneumonia. This patient's successful outcome might be attributable to early establishment of ECMO to prevent ventilation-induced lung injury.
Copyright ? 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.
KEYWORDS:
PVL; Panton-Valentine leukocidin; Staphylococcus aureus; influenza; leukocyte destruction; lung necrosis; membrane oxygenation; pneumonia
PMID:
25189914
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/25189914