Necrotizing pneumonia caused by community-acquired methicillin-resistant Staphylococcus aureus: an increasing cause of "mayhem in the lung"
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Updated: Jul 7, 2026

Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Mark D Ebert1, Sheila Sheth, Elliot K Fishman
1H. Russell Morgan Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. ebertmark@jhmi.edu
Abstract:
Although long recognized as a nosocomial organism, methicillin-resistant Staphylococcus aureus (MRSA) has been noted to have an increasing incidence in both immunocompromised and otherwise healthy people in the community. Community-acquired MRSA (CA-MRSA) is genetically distinct from hospital-acquired MRSA and frequently expresses the Panton-Valentine leukocidin toxin, which confers an aggressive necrotizing phenotype and is accompanied by a poor prognosis. We present a case of CA-MRSA pneumonia with the aim to alert the radiologist of the radiographic manifestations of this increasingly encountered and frequently fatal disease.
Insights
Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is a growing threat, causing aggressive pneumonia. Radiologists must recognize its distinct radiographic signs for timely diagnosis and improved patient outcomes.
Area of Science:
- Infectious Diseases
- Radiology
- Microbiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly prevalent in both hospital and community settings.
- Community-acquired MRSA (CA-MRSA) strains are genetically distinct and often produce Panton-Valentine leukocidin (PVL).
- PVL contributes to a severe necrotizing disease phenotype with poor prognosis.
Observation:
- Presents a case of CA-MRSA pneumonia.
- Highlights the radiographic manifestations of this infection.
- Emphasizes the need for radiologist awareness.
Findings:
- CA-MRSA pneumonia exhibits specific, recognizable radiographic features.
- Early identification of these features is crucial for patient management.
- The disease can be rapidly fatal if not promptly diagnosed.
Implications:
- Radiologists play a critical role in the early detection of CA-MRSA pneumonia.
- Increased awareness of CA-MRSA can lead to earlier intervention and potentially better outcomes.
- This case underscores the evolving landscape of infectious diseases and the importance of diagnostic imaging.
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