Fatal cases of Staphylococcus aureus pleural empyema in infants.

Pediatr Dev Pathol

Department of Pathology, CHU Sainte-Justine, 3175 chemin de la Côte-Ste-Catherine, Montréal, Quebec, Canada.

Published: December 2009

Community-associated infections and especially pleural empyema due to Staphylococcus aureus are increasing worldwide. The virulence of staphylococcal strains is notably determined by different toxin expressing-genes, such as the Panton-Valentine leukocidin (PVL) gene found in S. aureus isolates obtained from pediatric necrotizing pneumonia samples. We describe 2 similar cases of infants with severe respiratory distress and death after an upper respiratory tract infection, having occurred in the same urban area during the same winter time. Necropsies performed between November 2006 and March 2007 revealed bronchopneumonia and an important pleural empyema, justifying the review of clinical charts and laboratory exams. A methicillin-sensitive S. aureus (MSSA) isolate carrying the PVL gene was identified in both cases. We have subsequently cared for an additional case in the same time interval with sudden death and similar pathological findings. No positive microbiological results were obtained, a negative finding possibly related to a 5-day antibiotics regimen. This report describes the pathological features of these cases and stresses the need to recognize PVL-positive S. aureus infections in young children. Finally, we believe that all lethal infections due to PVL-positive S. aureus, independently of the methicillin resistance profile, deserve a mandatory report to the provincial public health authorities.

Download full-text PDF

Source
http://dx.doi.org/10.2350/08-09-0531.1DOI Listing

Publication Analysis

Top Keywords

pleural empyema
12
staphylococcus aureus
8
pvl gene
8
pvl-positive aureus
8
aureus
6
fatal cases
4
cases staphylococcus
4
aureus pleural
4
empyema infants
4
infants community-associated
4

Similar Publications

Pleural thickening can be the result of inflammation or infection but can also have a neoplastic origin. Depending on the clinical context, a pleural lesion or mass is often initially suspected of malignancy. Benign pleural tumors are rare, and their appearance on ultrasound (US) is also described less frequently than pleural metastases or malignancies.

View Article and Find Full Text PDF

The bronchopleural fistula (BPF) is a pathological passageway between the bronchus and the pleural cavity. Diagnosing and localising BPF can be challenging, and the traditional retrograde methylene blue (MB) perfusion method may fail to identify multifocal BPFs. This article reports a novel method for locating multifocal BPFs in patients undergoing concurrent empyema debridement.

View Article and Find Full Text PDF

Background: Empyema, characterized by the accumulation of pus in the pleural cavity, poses significant treatment challenges. While intrapleural tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) therapy is effective for many patients, a substantial proportion require surgical intervention, such as video-assisted thoracoscopic surgery (VATS), following treatment failure. Identifying tPA/DNase treatment failure-associated predictors is crucial for optimizing patient management and improving outcomes.

View Article and Find Full Text PDF

Background: Pleural diseases is a common respiratory disorder, mainly characterized as pleural effusion and patients with pleural effusion caused by pneumonia and empyema constituted 29% of the cohort, which suggests pleural infection as the predominant etiology of pleural effusion in China. Medical thoracoscopy (MT) combined with intrapleural injection of Urokinase holds significant therapeutic value for patients with early to moderate-stage empyema. However, there remains a lack of high-quality evidence regarding the efficacy and safety of combining MT with intrapleural injection of Urokinase administration in patients with pleural infections.

View Article and Find Full Text PDF

Surgery for chronic pyothorax after failed amplatzer closure of bronchopleural fistula.

J Cardiothorac Surg

January 2025

Department of Thoracic and Vascular Surgery, and Lung Transplantation, Marie-Lannelongue Hospital, Le Plessis-Robinson, France.

Background: Post-pneumonectomy bronchopleural fistula (BPF) is a life-threatening event whose treatment is not standardized.

Case Presentation: We report the management of a 28-year-old patient with a 3-year history of BPF complicating right pneumonectomy for congenital emphysema. Despite closure by an Amplatzer device, the patient had chronic pyothorax and severely deteriorated general health and quality of life.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!