PDF(Pubmed)
Abstract：
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia has well-defined characteristics. We present a case of cavitary pneumonia due to MRSA in a patient who had undergone a recent outpatient gastroscopic procedure. CASE REPORT A 32-year-old man presented at the Emergency Department with tonic-clonic seizures of 2 min durations. He had a history of seizures without current treatment or use of psychostimulant drugs. His personal history referred to hypothyroidism treated with levothyroxine, morbid type 3 obesity, gastritis with a gastric ulcer, penicillin allergies, and an ambulatory endoscopy with a biopsy (7 days ago) for erosive gastropathy. On the 3rd day of admission to the Intensive Care Unit (ICU), a bronchoscopy was performed, which showed a reddened mucosa with hemorrhagic points and a cavitary area in the right main bronchus. Multiple polymerase chain reaction and mass spectrometry analyses of samples of bronchioalveolar lavage from the bronchus revealed MRSA with a mechanism of resistance to the mecA gene (1×10⁵ colony-forming unit/mL). The laboratory results for the cerebrospinal fluid were negative for bacterial growth. CONCLUSIONS This is a rare case of cavitary pneumonia due to MRSA of clinical and epidemiological characteristics, which is unusual after an outpatient endoscopic procedure.
摘要：
背景技术耐甲氧西林金黄色葡萄球菌(MRSA)肺炎具有明确的特征。我们介绍了一例因MRSA引起的空洞性肺炎，该患者最近接受了门诊胃镜检查。病例报告一名32岁男子出现在急诊科，持续2分钟的强直阵挛性癫痫发作。他有癫痫发作史，没有目前的治疗或使用精神兴奋剂药物。他的个人病史涉及左旋甲状腺素治疗的甲状腺功能减退，病态3型肥胖，胃炎伴胃溃疡,青霉素过敏,和动态内镜活检（7天前）糜烂性胃病。在入住重症监护病房（ICU）的第3天，做了支气管镜检查,显示粘膜发红，出血点和右主支气管的空洞区域。来自支气管的支气管肺泡灌洗样品的多重聚合酶链反应和质谱分析显示，MRSA具有对mecA基因的抗性机制（1×10商业性集落形成单位/mL）。脑脊液的实验室结果为细菌生长阴性。结论这是一例罕见的由MRSA的临床和流行病学特征引起的空洞性肺炎,这在门诊内窥镜手术后是不寻常的。
