Community-associated methicillin-resistant Staphylococcus aureus is a frequent cause of skin and soft-tissue infections and is increasingly identified as a cause of pneumonia in immunocompetent patients. Panton-Valentine leukocidin, one of several leukocytotoxic peptides secreted by these cocci, is associated with increased virulence. A cluster of 3 unrelated patients with fatal pneumonia presumably caused by community-associated methicillin-resistant S aureus positive for Panton-Valentine leukocidin were treated in a 3-week period. Despite aggressive care and appropriate, timely administration of antibiotics, all 3 patients died. This article reviews the clinical and laboratory features suggestive of this lethal isolate, including unique findings on Gram stains of sputum.
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1 July 2013
Cases of Note|
July 01 2013
A Cluster of Fulminant, Fatal Necrotizing Community-Associated Methicillin-Resistant Staphylococcus aureus Pneumonias
Aparajita Sohoni, MD;
Aparajita Sohoni, MD
Aparajita Sohoni is faculty, Department of Emergency Medicine, Larry Lambert is the director, Microbiology Laboratory, and Robert McCabe is chief, Infectious Disease Division, Alameda County Medical Center, Oakland, California. Colin Feeney is the director, Critical Care Division, Alameda County Medical Center, and clinical professor of medicine, University of California San Francisco, San Francisco, California.
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Colin Feeney, MD;
Aparajita Sohoni is faculty, Department of Emergency Medicine, Larry Lambert is the director, Microbiology Laboratory, and Robert McCabe is chief, Infectious Disease Division, Alameda County Medical Center, Oakland, California. Colin Feeney is the director, Critical Care Division, Alameda County Medical Center, and clinical professor of medicine, University of California San Francisco, San Francisco, California.
Corresponding author: Colin Feeney, md, facp, Director, Critical Care Division, Alameda County Medical Center, 1411 E 31st St, Oakland, CA 94602 (e-mail: cfeeney@acmedctr.org).
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Larry Lambert, MPH;
Larry Lambert, MPH
Aparajita Sohoni is faculty, Department of Emergency Medicine, Larry Lambert is the director, Microbiology Laboratory, and Robert McCabe is chief, Infectious Disease Division, Alameda County Medical Center, Oakland, California. Colin Feeney is the director, Critical Care Division, Alameda County Medical Center, and clinical professor of medicine, University of California San Francisco, San Francisco, California.
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Robert McCabe, MD
Robert McCabe, MD
Aparajita Sohoni is faculty, Department of Emergency Medicine, Larry Lambert is the director, Microbiology Laboratory, and Robert McCabe is chief, Infectious Disease Division, Alameda County Medical Center, Oakland, California. Colin Feeney is the director, Critical Care Division, Alameda County Medical Center, and clinical professor of medicine, University of California San Francisco, San Francisco, California.
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Am J Crit Care (2013) 22 (4): 364–367.
Citation
Aparajita Sohoni, Colin Feeney, Larry Lambert, Robert McCabe; A Cluster of Fulminant, Fatal Necrotizing Community-Associated Methicillin-Resistant Staphylococcus aureus Pneumonias. Am J Crit Care 1 July 2013; 22 (4): 364–367. doi: https://doi.org/10.4037/ajcc2013644
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