PDF(Pubmed)
Abstract：
BACKGROUND The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) has been increasing in recent years, becoming a cause of community-acquired infection. Interestingly, its role in malignancy recently started to be considered after a noticed increase in reported cases and studies discussing the potential association. CASE REPORT In the present case, the patient had known and uncontrolled diabetes mellitus and a history of multiple abscesses that were previously treated by incision and drainage. The patient received a diagnosis of severe pneumonia, and MRSA was found in blood cultures. Further tests for HIV, hemagglutinin type 1, and neuraminidase type 1 (H1N1) were negative. The D test was also performed for macrolide-inducible resistance and was negative, indicating the need for intravenous administration of clindamycin. An echocardiogram ruled out endocarditis. Subsequently, the patient experienced progressive back pain and weakness involving the lower limbs. A pathological fracture was discovered, along with nerve root compression. An urgent posterior spine fixation was then performed by a neurosurgeon. A biopsy was collected at the site of the pathological fracture, and histopathological tests indicated a plasma cell neoplasm. CONCLUSIONS MRSA is known to cause serious and dangerous infections, including necrotizing pneumonia. Furthermore, a link between MRSA and plasma cell dyscrasia has been considered in several reports. This necessitates the need for further studies to clarify this hidden association, which may help in the course and prognosis of these patients.
摘要：
背景技术耐甲氧西林金黄色葡萄球菌(MRSA)的患病率近年来一直在增加。成为社区获得性感染的原因。有趣的是,在报告的病例和讨论潜在关联的研究增加后，最近开始考虑其在恶性肿瘤中的作用。案例报告在本案中，患者已知有未控制的糖尿病,并且有多发性脓肿病史,以前曾通过切开引流术治疗.病人被诊断为重症肺炎,在血液培养中发现了MRSA。艾滋病毒的进一步检测，血凝素1型和神经氨酸酶1型（H1N1）阴性。对大环内酯诱导抗性也进行了D检验，结果为阴性，表明需要静脉注射克林霉素。超声心动图排除了心内膜炎。随后，患者出现累及下肢的进行性背痛和无力。发现了病理性骨折，伴随神经根压迫。然后由神经外科医生进行紧急的后路脊柱固定。在病理性骨折部位收集活检，组织病理学检查显示浆细胞肿瘤。结论已知MRSA会导致严重和危险的感染，包括坏死性肺炎.此外，在一些报道中已经考虑了MRSA和浆细胞发育不良之间的联系。这就需要进一步的研究来澄清这种隐藏的关联，这可能有助于这些患者的病程和预后。
