Pneumonia caused by coagulase - positive methicillin - resistant Staphylococcus aureus

Abstract

Introduction. Staphylococcus (S.) aureus is one of the most omnipresent and dangerous human pathogens, whose main characteristic is the production of the enzyme coagulase. This characteristic serves to identify and assess the pathogenicity of the bacteria. In addition to skin infections, endocarditis, osteomyelitis, and infectious arthritis, it is a common cause of pneumonia both in children and adults. Case report. We described a case of a 65-year-old woman with a dry cough and malaise with patchy areas of consolidation on the chest X-ray and “ground-glass” opacity with bronchial wall thickening and unilateral mediastinal lymphadenopathy on chest computed tomography imaging. Methicillin-resistant S. aureus was isolated from the bronchoalveolar aspirate taken during bronchoscopy. The woman was empirically treated with azithromycin, and later, based on the antibiogram findings, azithromycin was replaced with meropenem, after which her health improved. Conclusion. We presented a rare case of pneumonia with unconvincing symptomatology and laboratory and radiological findings. Paying more attention to such cases in the future is crucial, especially to the use of antibiotics to which staphylococci are increasingly developing resistance.

Keywords

• antibiotics
• bronchoscopy
• coagulase
• methicillin resistance
• pneumonia
• staphylococcus aureus