Anestéziológia a intenzívna medicína 2/2015

Methicillin-sensitive Staphylococcus aureus producing Panton-Valentine leukocidin as the cause of haemorrhagic necrotizing pneumonia. First documented case in Slovak Republic

Staphylococcus aureusproducing Panton-Valentine leukocidin (PVL) toxin is mostly associated with skin and soft tissues infections. In rare cases, it may be cause of community acquired haemorrhagic necrotizing pneumonia with very high mortality. In the last decades, there has been an increase in the incidence of necrotizing lung infections in otherwise healthy young people. We present the case of a previously healthy woman, who came to the hospital because of strong back pain, followed by the rapid development of necrotizing pneumonia associated with hemoptysis, leukopenia, developing ARDS (acute respiratory distress syndrome), septic shock and DIC (disseminated intravascular coagulation). This case shows some typical features of this community acquired pneumonia, when we should think about PVL producing S. aureus. Despite the very difficult course of the disease, significant destruction of lung parenchyma and many complications during hospitalization, the patient survived without any consequences. Early suspicion of this toxin and prompt starting of the right therapy and good interdisciplinary cooperation was probably the key point in this case. In our best knowledge, this is the first documented case of PVL-associated hemoragic-necrotizing pneumonia in Slovak republic.

Keywords: Staphylococcus aureus, Panton-Valentine leukocidin, community-acquired pneumonia.