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Case ReportCase Reports

A Case of Rapidly Progressive Necrotizing Pneumonia Caused by Community-Acquired Methicillin-Resistant Staphylococcus aureus

Robert P Dickson, Shay M Martinez and Justin R Ortiz
Respiratory Care September 2008, 53 (9) 1223-1226;
Robert P Dickson
Department of Medicine
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  • For correspondence: [email protected]
Shay M Martinez
Department of Medicine
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Justin R Ortiz
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Harborview Medical Center, University of Washington, Seattle, Washington
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Abstract

We present the case of a patient with a necrotizing multilobar pneumonia caused by community-acquired methicillin-resistant Staphylococcus aureus (MRSA). The patient presented with shortness of breath and a productive cough of 3 days duration. On arrival to the emergency department she was intubated for increased work of breathing and given vasopressors for hypotension refractory to fluid resuscitation. Blood cultures taken at admission, sputum cultures from the patient's endotracheal tube, and bronchoalveolar lavage cultures all grew S. aureus resistant to penicillinase-resistant penicillins. Over the following days the patient's respiratory function deteriorated as she grew progressively hypoxemic and hypercarbic despite aggressive mechanical ventilation and intravenous antibiotics. On day 4 of her hospitalization a computed tomogram revealed extensive pulmonary necrosis consistent with necrotizing pneumonia. The patient's family elected to withdraw support, and the patient rapidly died following cessation of mechanical ventilation.

  • pneumonia
  • bacterial
  • staphylococcus aureus
  • respiratory insufficiency
  • methicillin-resistant staphylococcus aureus
  • MRSA

Footnotes

  • Correspondence: Robert P Dickson MD, Department of Medicine, University of Washington Medical Center, 4245 Roosevelt Way NE, Seattle Washington 98105-6920. E-mail: rpd4{at}u.washington.edu.
  • The authors report no conflicts of interest related to the content of this paper.

  • Copyright © 2008 by Daedalus Enterprises Inc.
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Respiratory Care: 53 (9)
Respiratory Care
Vol. 53, Issue 9
1 Sep 2008
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A Case of Rapidly Progressive Necrotizing Pneumonia Caused by Community-Acquired Methicillin-Resistant Staphylococcus aureus
Robert P Dickson, Shay M Martinez, Justin R Ortiz
Respiratory Care Sep 2008, 53 (9) 1223-1226;

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A Case of Rapidly Progressive Necrotizing Pneumonia Caused by Community-Acquired Methicillin-Resistant Staphylococcus aureus
Robert P Dickson, Shay M Martinez, Justin R Ortiz
Respiratory Care Sep 2008, 53 (9) 1223-1226;
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Keywords

  • pneumonia
  • bacterial
  • Staphylococcus aureus
  • respiratory insufficiency
  • methicillin-resistant staphylococcus aureus
  • MRSA

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