Details

Autor(en) / Beteiligte

• van Nieuwkoop, C
• Bernards, A T
• Compier, E A
• Kraemer, C V Elzo
• Visser, L G

Titel

Community-acquired Staphylococcus aureus pneumonia following influenza and the choice of empirical antibiotic treatment

Ist Teil von

• Nederlands tijdschrift voor geneeskunde, 2008-04, Vol.152 (14), p.822

Ort / Verlag

Netherlands

Erscheinungsjahr

2008

Quelle

MEDLINE

Beschreibungen/Notizen

• A 30-year-old man presented with community-acquired pneumonia (CAP), directly following influenza. Sputum Gram stain confirmed Staphylococcus aureus pneumonia. Initial empirical antimicrobial therapy did not cover S. aureus. The isolated S. aureus strain contained genes encoding exotoxins, such as Panton-Valentine leukocidin (PVL). This exotoxin is associated with high mortality and methicillin resistance, but in this patient the strain was susceptible to methicillin. The patient died. In the Netherlands the risk of methicillin resistance in PVL-positive S. aureus CAP is low but real. This should be taken into account when selecting empirical treatment, which can include the combination of flucloxacillin and rifampicin. This case report illustrates the difficulty in predicting the causative agent in CAP and highlights the usefulness of the sputum Gram stain. Moreover, clinical awareness and recognition of S. aureus CAP remains essential to the early initiation of directed therapy.