A Fatal Case of Necrotizing Pneumonia Caused by Community-Associated Methicillin-Resistant Staphylococcus aureus

Abstract

There have been increasing reports of methicillin-resistant Staphylococcus aureus (MRSA) infections developing in the community setting in patients without traditional risk factors for MRSA infection. We present a case of a 28-year-old patient that presented to the emergency room initially with upper respiratory symptoms that rapidly progressed to become critically ill with a necrotizing pneumonia, leukopenia, thrombocytopenia, and renal failure. The patient subsequently grew a MRSA isolate from bronchoalveolar lavage samples, which was found to carry SCCmec IV and to contain the Panton-Valentine leukocidin genes. We present this case to review the virulence, unique genomic characteristics, distinct antimicrobial susceptibility pattern, and potential complications associated with these community-associated MRSA isolates. As seen in our patient, community-associated MRSA infections often present with skin and soft tissue infections and may cause severe necrotizing pneumonia as well as other serious infections including fatal bacteremia.