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Drug-Resistant Pneumonia Emerging in Healthy People

Community-acquired meticillin-resistant Staphylococcus aureus exhibits flu-like symptoms

FRIDAY, May 22 (HealthDay News) -- Community-acquired meticillin-resistant Staphylococcus aureus (MRSA) is an emerging cause of pneumonia in otherwise healthy individuals, according to a case report and review in the June issue of The Lancet Infectious Diseases.

Alicia I. Hidron, M.D., from Emory University School of Medicine in Atlanta, and colleagues describe two related cases of community-acquired MRSA necrotizing pneumonia and conducted a literature review of community-acquired MRSA.

The cases involved a 45-year-old woman and her 36-year-old male partner. Both reported an influenza-like illness about a week before being admitted to the hospital for shortness of breath, fever, chills, and productive cough. Both were found to be infected with the MRSA USA300 genotype, and both eventually recovered after treatment with clindamycin and vancomycin. The literature review indicated that shortness of breath, sepsis, and hemoptysis were the most common symptoms, and that the best treatment of this partly toxin-mediated disease was unclear.

"This entity [community-acquired MRSA] should be suspected in patients presenting from the community with sepsis, hemoptysis, multilobar infiltrates, and leucopenia," Hidron and colleagues conclude. "In such patients, standard treatment of community-acquired pneumonia will be inappropriate, and an antibiotic with activity against MRSA (i.e., vancomycin or linezolid) should be included in the empirical regimen until culture results are available."

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