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Cholera-like diarrhea and shock associated with community-acquired methicillin-resistant Staphylococcus aureus

Allison Agwu1, Ken M Brady, Tracy Ross

  • 1Division of Pediatric Infectious Disease, Johns Hopkins University School of Medicine, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room w5041, Baltimore, MD 21205, USA.

The Pediatric Infectious Disease Journal
|May 9, 2007
PubMed

Insights

A severe case of Influenza A in a 14-year-old girl led to rapid death. This was associated with Panton-Valentine leukocidin-positive Staphylococcus aureus (CA-MRSA) infection.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Critical Care Medicine

Background:

  • Influenza A virus is a significant cause of respiratory illness.
  • Community-associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA) can cause severe invasive infections.
  • Co-infections can complicate disease presentation and outcomes.

Observation:

  • A 14-year-old female presented with severe watery diarrhea, vomiting, and hypotension.
  • The patient rapidly progressed to shock, multiorgan system failure, and death.
  • No initial respiratory prodrome was noted.

Findings:

  • Influenza A virus was detected in the nasopharynx.
  • A Panton-Valentine leukocidin (PVL)-positive CA-MRSA strain (USA400) was isolated from a tracheal aspirate.
  • The CA-MRSA strain carried genes for PVL (pvl), mecA, and enterotoxins (sea, sec, seh).

Implications:

  • This case highlights a rare and aggressive presentation of co-infection with Influenza A and PVL-positive CA-MRSA.
  • The combination of viral and bacterial pathogens may lead to rapid deterioration and fatal outcomes.
  • Understanding such synergistic infections is crucial for timely diagnosis and management in critical care settings.

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