Necrotizing Pneumonia Caused by Community-acquired Methicillin-resistant Staphylococcus aureus Following Influenza
Maiko Awashima, Yoshiko Kichikawa, Ko Suzuki, Hideyuki Horikoshi

Abstract
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TopicsAntimicrobial Resistance in Staphylococcus
A 39-year-old female was presented to our hospital with fever, dyspnea, and chest pain. She had been diagnosed with influenza virus infection and had received antiviral drugs two days earlier. Despite this, she experienced difficulty maintaining adequate oxygenation on room air. She was administered oxygen using a reservoir mask at 15 L/min. Chest computed tomography (CT) revealed bilateral infiltrates (Figure 1), and methicillin-resistant Staphylococcus aureus (MRSA) was detected in her sputum. By the 10th day of hospitalization, chest CT showed multiple cavitary lesions (Figure 2). She was diagnosed with necrotizing pneumonia caused by community-acquired MRSA (CA-MRSA) ^(1)^. Following the administration of Linezolid, her clinical condition improved. In Japan, reports of CA-MRSA pneumonia are rare, but most of them involve severe pneumonia with the destruction of lung tissue. Unlike healthcare-associated MRSA pneumonia, CA-MRSA pneumonia has a tendency for cavitation within infiltrates ^(2)^. Therefore, it is necessary to include CA-MRSA pneumonia in the differential diagnosis when encountering pneumonia with multiple cavitary lesions.
Article Information
Conflicts of Interest
None
Author Contributions
Maiko Awashima wrote the manuscript, and the other authors revised it.
Approval by Institutional Review Board (IRB)
This study did not require IRB approval.
Informed Consent
Consent was obtained from the patient.
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- 1Naimi TS, Le Dell KH, Como-Sabetti K, et al. Comparison of community- and health care-associated methicillin-resistant Staphylococcus aureus infection. JAMA. 2003;290(22):2976-84.14665659 10.1001/jama.290.22.2976 · doi ↗ · pubmed ↗
- 2Defres S, Marwick C, Nathwani D. MRSA as a cause of lung infection including airway infection, community acquired pneumonia and hospital-acquired pneumonia. Eur Respir J. 2009;34(6):1470-6.19948913 10.1183/09031936.00122309 · doi ↗ · pubmed ↗
