Near-fatal Panton-Valentine leukocidin-positive Staphylococcus aureus pneumonia,shock and complicated extracorporeal membrane oxygenation cannulation:A case report

作     者：Joshua Cuddihy Shreena Patel Nabeela Mughal Christopher Lockie Richard Trimlett Stephane Ledot Nicholas Cheshire Ajay Desai Suveer Singh 

作者机构：Magill Department for AnaesthesiaCritical Care and Pain MedicineChelsea and Westminster Hospital NHS Foundation TrustLondon SW109NHUnited Kingdom Department of Surgery and CancerImperial College LondonLondon SW72BUUnited Kingdom Chelsea and Westminster HospitalChelsea and Westminster Hospital NHS Foundation TrustLondon SW109NHUnited Kingdom Warwick Medical SchoolWarwick UniversityWarwick CV47HLUnited Kingdom Microbiology and Infectious DiseasesChelsea and Westminster Hospital NHS Foundation TrustLondon SW109NHUnited Kingdom Imperial College LondonImperial College LondonLondon SW72BUUnited Kingdom Intensive Care UnitChelsea and Westminster Hospital NHS Foundation TrustLondon SW109NHUnited Kingdom Cardiac SurgeryRoyal Brompton and Harefield NHS Foundation TrustLondon SW36NPUnited Kingdom Adult Intensive Care UnitRoyal Brompton and Harefield NHS Foundation TrustLondon SW36NPUnited Kingdom Vascular SurgeryRoyal Brompton and Harefield NHS Foundation TrustLondon SW36NPUnited Kingdom Paediatric Intensive Care UnitRoyal Brompton and Harefield NHS Foundation TrustLondon SW36NPUnited Kingdom 

出 版 物：《World Journal of Critical Care Medicine》 (世界重症医学杂志)

年 卷 期：2021年第10卷第5期

页      面：301-309页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Panton-Valentine leukocidin-Staphylococcus aureus Adolescent Extracorporeal membrane oxygenation Extracorporeal cardiopulmonary resuscitation Case report 

摘      要：BACKGROUND Panton-Valentine leukocidin(PVL)is an exotoxin secreted by Staphylococcus aureus(***),responsible for skin and soft tissue *** a cause of severe necrotising pneumonia,it is associated with a high mortality rate.A rare entity,the epidemiology of PVL ***(PVL-SA)pneumonia as a complication of influenza coinfection,particularly in young adults,is incompletely *** SUMMARY An adolescent girl presented with haemoptysis and respiratory distress,deteriorated rapidly,with acute respiratory distress syndrome(ARDS)and profound shock requiring extensive,prolonged resuscitation,emergency critical care and venovenous extracorporeal membrane oxygenation(ECMO).Cardiac arrest and a rare complication of ECMO cannulation necessitated intra-procedure extracorporeal cardiopulmonary resuscitation,i.e.,venoarterial *** infectious disease,microbiology and Public Health England engagement identified causative agents as PVL-SA and influenza A/H3N2 from bronchial aspirates within *** further complications of critical illness,the patient made an excellent recovery with normal cognitive *** coordinated approach of numerous multidisciplinary specialists,nursing staff,infection control,specialist cardiorespiratory support,hospital services,both adult and paediatric and Public Health are testimony to what can be achieved to save life against expectation,against the *** case serves as a reminder of the deadly nature of PVL-SA when associated with influenza and describes a rare complication of ECMO *** PVL-SA can cause severe ARDS and profound shock,with influenza infection.A timely coordinated multispecialty approach can be lifesaving.