关键词: Clindamycin Clindamycine Leucocidine de Panton-Valentine Linezolid Linézolide Necrotizing pneumonia Panton-Valentine leukocidin Pneumopathie nécrosante Staphylococcus aureus

Mesh : Aged Anti-Bacterial Agents / therapeutic use Bacterial Toxins Exotoxins / metabolism Female Humans Leukocidins / metabolism Lung / microbiology pathology Necrosis / microbiology Pneumonia, Staphylococcal / diagnosis drug therapy microbiology Radiography, Thoracic Staphylococcus aureus / isolation & purification metabolism

来  源:   DOI:10.1016/j.rmr.2017.01.006   PDF(Sci-hub)

Abstract:
BACKGROUND: Some strains of Staphylococcus aureus produce a toxin known as Panton-Valentine leukocidin. These strains notably cause a necrotizing pneumonia which is associated with a high mortality.
METHODS: A 70-year-old woman presented with sub-acute onset dyspnea, low-grade fever, and hemoptysis after a trip to Dubai and New Zealand. Computed tomography showed bilateral necrotizing pneumonia, suggesting the diagnosis of pneumonia caused by S. aureus producing Panton-Valentine toxin. It was confirmed by microbiological investigation. The rapid initiation of adequate antimicrobial therapy including an effective antitoxin was essential for successful treatment, without the need for ventilatory support.
CONCLUSIONS: Necrotizing pneumonia caused by S. aureus producing Panton-Valentine leukocidin usually occurs in young subjects without comorbidities. Typical symptoms are a combination of hypoxemia, high fever, hemoptysis, leukopenia, and a rapidly worsening condition. Panton-Valentine leukocidin should not be discarded if not all the symptoms are typical. Antibiotic therapy including an antitoxin drug such as linezolid or clindamycin should be initiated promptly.
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