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Updated: Dec 17, 2025
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Community-acquired pneumonia caused by methicillin-resistant Staphylococcus aureus in a Chinese adult: A case report
Huan Xia1, Jinying Gao1, Ming Xiu2
1Department of Respiratory Medicine.
Rationale:
Methicillin-resistant Staphylococcus aureus (MRSA) has been established as an important cause of severe community-acquired pneumonia (CAP) with very high mortality. Panton-Valentine leukocidin (PVL) producing MRSA has been reported to be associated with necrotizing pneumonia and worse outcome. The incidence of community-acquired MRSA (CA-MRSA) pneumonia is very low, as only a few CA-MRSA pneumonia cases were reported in the last few years. We present a case of severe CAP caused by PVL-positive MRSA with ensuing septic shock.
Patient Concerns:
A 68-year-old male with no concerning medical history had developed a fever that reached 39.0°C, a productive cough that was sustained for 5 days, and hypodynamia. He was treated with azithromycin and alexipyretic in a nearby clinic for 2 days in which the symptoms were alleviated. However, 1 day later, the symptoms worsened, and he was taken to a local Chinese medicine hospital for traditional medicine treatment. However, his clinical condition deteriorated rapidly, and he then developed dyspnea and hemoptysis.
Diagnosis:
CA-MRSA pneumonia and septic shock. The sputum culture showed MRSA. Polymerase chain reaction of MRSA isolates was positive for PVL genes.
Interventions:
Mechanical ventilation, fluid resuscitation, and antibiotic therapy were performed. Antibiotic therapy included mezlocillin sodium/sulbactam sodium, linezolid, and oseltamivir.
Outcomes:
He died after 12 hours of treatment.
Lessons:
This is a report of severe pneumonia due to PVL-positive CA-MRSA in a healthy adult. CA-MRSA should be considered a pathogen of severe CAP, especially when combined with septic shock in previously healthy individuals.
Insights
Severe community-acquired pneumonia caused by Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus (PVL-MRSA) can rapidly lead to septic shock and death, even in healthy individuals. This rare CA-MRSA pneumonia case highlights the critical need for prompt diagnosis and treatment.
Area of Science:
- Infectious Diseases
- Pulmonology
- Critical Care Medicine
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of severe community-acquired pneumonia (CAP) with high mortality.
- Panton-Valentine leukocidin (PVL)-producing MRSA is associated with necrotizing pneumonia and poorer outcomes.
- Community-acquired MRSA (CA-MRSA) pneumonia is rare, with few cases reported previously.
Observation:
- A 68-year-old male with no prior medical history presented with symptoms of severe CAP, including high fever, productive cough, and hypodynamia.
- Despite initial treatment, his condition rapidly deteriorated, leading to dyspnea and hemoptysis.
- Diagnosis confirmed CA-MRSA pneumonia with septic shock, with MRSA isolates testing positive for PVL genes.
Findings:
- The patient received mechanical ventilation, fluid resuscitation, and broad-spectrum antibiotics including mezlocillin sodium/sulbactam sodium, linezolid, and oseltamivir.
- Despite intensive treatment, the patient succumbed to the infection 12 hours after admission.
- This case underscores the aggressive nature of PVL-positive CA-MRSA pneumonia.
Implications:
- CA-MRSA should be recognized as a potential pathogen in severe CAP, particularly in previously healthy individuals presenting with rapid deterioration.
- The presence of PVL in MRSA strains may indicate a higher risk of severe necrotizing pneumonia and septic shock.
- Prompt recognition and aggressive management are crucial for improving outcomes in patients with PVL-positive CA-MRSA pneumonia.
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