Cunning and community-acquired pneumonia

• Published in: The Lancet (British edition) 2009-01, Vol.373 (9659), p.270-270
• Main Authors: Broadfield, Emma, Dr, Doshi, Neelam, FRCPath, Alexander, Peter DG, FRCA, Greaves, Melanie, MRCR, Woodcock, Ashley, Prof
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Antibiotics; Biological and medical sciences; Community-Acquired Infections - drug therapy; Community-Acquired Infections - physiopathology; Female; General aspects; Heart rate; Hospitals; Humans; Illnesses; Infant, Newborn; Internal Medicine; Male; Medical sciences; Methicillin-Resistant Staphylococcus aureus - classification; Methicillin-Resistant Staphylococcus aureus - isolation & purification; Mortality; Nitric oxide; Pneumonia - drug therapy; Pneumonia - microbiology; Pneumonia - physiopathology; Pregnancy; Staphylococcal Infections - drug therapy; Staphylococcal Infections - physiopathology; Staphylococcus infections; Toxins; Ventilation; Young Adult
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(09)60074-X

In view of the patient's deteriorating prognosis, the baby, a healthy boy, was delivered by emergency caesarean section, 36 h after admission. Pneumonia caused by the PVL strain has a reported mortality of 75%.1 Although S aureus classically causes pneumonia in elderly people with pre-existing illness, the PVL strain typically infects well, young people (median age 15 years).1 Typical features of illness include: temperature greater than 39°C; respiratory rate greater than 40 breaths per min; heart rate greater than 140 beats per min; hypotension; leucopenia; and haemoptysis.2 In a UK study, Iufc-P V was found in 1-6% of S aureus isolates, most, but not all, of which were sensitive to meticillin.3 The PVL strain cannot be treated by standard regimens for community-acquired pneumonia, β-lactam antibiotics, including penicillins and cefalosporins, may increase toxin formation.