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Acute respiratory distress syndrome due to methicillin-resistant Staphylococcus aureus sepsis in hyper-IgE syndrome
1First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Abstract:
We report the case of a 34 year old woman with acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC) due to methicillin-resistant Staphylococcus aureus (MRSA) sepsis with hyperimmunoglobulin E syndrome (HIES). Although chemotactic activity of neutrophils was impaired in this patient, neutrophils accumulated in the lungs as assessed by bronchoalveolar lavage fluid (BALF) counts. In addition to antibiotics and oxygen therapy, the administration of recombinant human granulocyte colony-stimulating factor (rhG-CSF) resulted in a remarkable recovery.
Insights
A patient with severe MRSA sepsis, ARDS, and DIC, despite impaired neutrophil function, recovered remarkably after treatment with rhG-CSF alongside standard care. This highlights a potential therapeutic role for rhG-CSF in complex sepsis cases.
Area of Science:
- Immunology
- Critical Care Medicine
- Infectious Diseases
Background:
- Hyperimmunoglobulin E syndrome (HIES) is a primary immunodeficiency characterized by recurrent staphylococcal infections and elevated IgE.
- Sepsis, particularly from methicillin-resistant Staphylococcus aureus (MRSA), can lead to severe complications like acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC).
- Neutrophil dysfunction is a hallmark of HIES, potentially impairing host defense against bacterial infections.