Intensive Care Medicine

, Volume 29, Issue 10, pp 1840–1843

Life-threatening hemoptysis in adults with community-acquired pneumonia due to Panton-Valentine leukocidin-secreting Staphylococcus aureus

  • Véronique Boussaud
  • Antoine Parrot
  • Charles Mayaud
  • Marie Wislez
  • Martine Antoine
  • Clément Picard
  • Françoise Delisle
  • Jérome Etienne
  • Jacques Cadranel
Brief Report

DOI: 10.1007/s00134-003-1918-5

Cite this article as:
Boussaud, V., Parrot, A., Mayaud, C. et al. Intensive Care Med (2003) 29: 1840. doi:10.1007/s00134-003-1918-5

Abstract

Three new consecutive cases of life-threatening hemoptysis in adults with community-acquired pneumonia due to Panton-Valentine leukocidin-secreting Staphylococcus aureus are presented, focusing on the particular clinical presentation of this new entity. Between December 1999 and March 2001, three adults aged from 23 to 67 years were admitted to our respiratory intensive care unit for massive hemoptysis and septic shock associated with community-acquired Staphylococcus aureus pneumonia. Isolates were sent to the Centre National de Référence des Toxémies Staphylococciques in Lyon, France, where they were found to secrete Panton-Valentive leukocidin. The clinical course was similar in the three patients, with massive hemoptysis and septic shock necessitating mechanical ventilation. Two patients died rapidly; necropsy showed pulmonary vascular necrosis in one of them. The third patient recovered after appropriate antibiotic therapy. Leukocidin/neutrophil interactions in the pulmonary vasculature may cause severe hemoptysis in patients with community-acquired Staphylococcus aureus pneumonia secreting Panton-Valentine leukocidin. Adult patients with massive hemoptysis and suspected community-acquired pneumonia should receive antibiotic regimens covering Staphylococcus aureus.

Keywords

Staphylococcus aureusPneumoniaHemoptysisAdult respiratory distress syndrome (ARDS)

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Véronique Boussaud
    • 1
  • Antoine Parrot
    • 1
  • Charles Mayaud
    • 1
  • Marie Wislez
    • 1
  • Martine Antoine
    • 2
  • Clément Picard
    • 1
  • Françoise Delisle
    • 3
  • Jérome Etienne
    • 4
  • Jacques Cadranel
    • 1
  1. 1.Service de Pneumologie et de Réanimation RespiratoireHôpital Tenon-Université Paris VIParisFrance
  2. 2.Service d'Anatomie-pathologiqueHôpital Tenon-Université Paris VIParisFrance
  3. 3.Service de BactériologieHôpital Tenon-Université Paris VIParisFrance
  4. 4.Centre National de Références des Toxémies Staphylococciques, INSERM E0230, IFR 62Faculté de Médecine, Université Claude Bernard Lyon ILyon cedex 08France