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Successful use of venovenous extracorporeal membranous oxygenation in a 22-month old boy with necrotizing pneumonia, osteomyelitis and septic shock caused by Panton Valentine leukocidin – producing Staphylococcus aureus
1Department of Paediatric Surgery and Intensive Care, University Medical Centre
2Department of Paediatric Surgery and Intensive Care, University Medical Centre
3,Department of Infectious Diseases University Medical Centre
4,Department of Cardiovascular Surgery University Medical Centre
*Corresponding Author(s): MOJCA GROSELJ-GRENC E-mail: mojca.groselj@kclj.si
Extracorporeal membrane oxygenation (ECMO) is a life saving treatment for patients with severe respiratory failure. We present a case of a young child with invasive Panton Valentine leukocidin-producing Staphylococcus aureus infection, which is responsible for severe and invasive infection with a high mortality rate, commonly associated with necrotizing pneumonia. Our patient presented with septic shock and necrotizing pneumonia leading to severe respiratory failure, refrac-tory to conventional ventilation means. After 1-day of treatment, venovenous ECMO (VV ECMO) was successfully instituted and inotropic support was gradually decreased. Acute renal failure was managed with peritoneal dialysis and intermittent venovenous hemofiltration. The patient was weaned from ECMO 9-days later and was mechanically ventilated for another 3 weeks. Necrotizing pneumonia with pleuropulmonary complications was finally managed by videothoracoscopy with evacuation of debris and partial pleural decortication. Osteomyelitis was confirmed by positron emission tomography – computed tomography (PET-CT) and was surgically treated. The child was treated with antistaphylococcal antibiotic therapy for 54 days. Finally, he was discharged to a rehabilitation center without supplemental oxygen and with his neurologic status at his baseline. Our case shows that VV ECMO can be applied to children with severe bacterial pneumonia resistant to conventional ventilation strategies and with moderate circulatory failure.
extracorporeal mem-branous oxygenation, septic shock, Staphylococcus aureus pneumonia, Staphylococcus aureus, Panton Val-entine leukocidin, child
MOJCA GROSELJ-GRENC,GORAZD KALAN,IVAN VIDMAR,ANDREJA SKOFLJANEC,MARKO POKORN,JANEZ VODISKAR. Successful use of venovenous extracorporeal membranous oxygenation in a 22-month old boy with necrotizing pneumonia, osteomyelitis and septic shock caused by Panton Valentine leukocidin – producing Staphylococcus aureus. Signa Vitae. 2011. 6(2);82-85.
1. Hansell DR. Extracorporeal membrane oxygenation for perinatal and pediatric patients. Respir Care 2003;48:352-62.
2. Schuerer DJ, Kolovos NS, Boyd KV, Coopersmith CM. Extracorporeal membrane oxygenation: current clinical practice, coding, and reim-bursement. Chest 2008;134: 179-84.
3. Stroud MH, Okhuysen-Cawley R, Jaquiss R, Berlinski A, Fiser RT. Successful use of extracorporeal membrane oxygenation in severe necrotizing pneumonia caused by Staphylococcus aureus. Pediatr Crit Care Med 2007;8:282-7.
4. Otter JA, French GL. Molecular epidemiology of community-associated meticillin-resistant Staphylococcus aureus in Europe. Lancet 2010;10:227-39.
5. Brierley J, Carcillo JA, Choong K, Cornell T, Decaen A, Deymann A, et al. Clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock: 2007 update from the American College of Critical Care Medicine. Crit Care Med 2009;37:666-88.
6. Vidmar I, Primoži J, Kalan G, Grosek Š. Extracorporeal membranous oxygenation (ECMO) in neonates and children - experiences of a multidisciplinary paediatric intensive care unit. Signa vitae 2008;3(suppl. 1):17-21.
7. Lequier L. Extracorporeal life support in pediatric and neonatal critical care: a review. J Intensive Care Med 2004;19:243-58.
8. Betit P. Extracorporeal membrane oxygenation: quo vadis? Respir Care 2009;54:948-57.
9. Nourse C, Starr M, Munckhof W. Community-acquired methicillin-resistant Staphylococcus aureus causes severe disseminated infection and deep venous thrombosis in children: literature review and recommendations for management. J Paediatr Child Health 2007;43:656-61.
10. Kefala-Agoropoulou K, Protonotariou E, Vitti D, Sarafidou S, Anastasiou A, Kollios K, et al. Life-threatening infection due to community-acquired methicillin-resistant Staphylococcus aureus: case report and review. Eur J Pediatr 2010;169:47-53.
11. Thomas B, Pugalenthi A, Chilvers M. Pleuropulmonary complications of PVL-positive Staphylococcus aureus infection in children. Acta Paediatr 2009; 98: 1372-5.
12. Obando I, Valderrabanos ES, Millan JA, Neth OW. Necrotising pneumonia due to influenza A (H1N1) and community-acquired methi-cillin-resistant Staphylococcus aureus clone USA300: successful management of the first documented paediatric case. Arch Dis Child 2010;95:305-6.
13. Moumile K, Cadilhac C, Lina G, Berche P, Glorion C, Ferroni A. Severe osteoarticular infection associated with Panton-Valentine leukocidin-producing Staphylococcus aureus. Diagn Microbiol Infect Dis 2006;56:95-7.
14. Tseng MH, Wei BH, Lin WJ, Lu JJ, Lee SY, Wang SR, et al. Fatal sepsis and necrotizing pneumonia in a child due to community-acquired methicillin-resistant Staphylococcus aureus: case report and literature review. Scand J Infect Dis 2005;37: 504-7.
15. Mushtaq F, Hildrew S, Okugbeni G, Ellis RW, Deshpande S. Necrotizing haemorrhagic pneumonia proves fatal in an immunocompetent child due to Panton-Valentine Leucocidin, toxic shock syndrome toxins 1 and 2 and enterotoxin C-producing Staphylococcus aureus. Acta Paediatr 2008;97:985-7.
16. Gillet Y, Issartel B, Vanhems P, Fournet JC, Lina G, Bes M, et al. Association between Staphylococcus aureus strains carrying gene for Panton-Valentine leukocidin and highly lethal necrotising pneumonia in young immunocompetent patients. Lancet 2002;359:753-9.
17. Creech CB, Johnson BG, Bartilson RE, Yang E, Barr FE. Increasing use of extracorporeal life support in methicillin-resistant Staphylococcus aureus sepsis in children. Pediatr Crit Care Med 2007;8:231-5.
18. Zahraa JN, Moler FW, Annich GM, Maxvold NJ, Bartlett RH, Custer JR. Venovenous versus venoarterial extracorporeal life support for pediatric respiratory failure: are there differences in survival and acute complications? Crit Care Med 2000;28:521-5.
19. Noah MA, Dawrant M, Faulkner GM, Hill AM, Harvey C, Hussain A, et al. Panton-Valentine leukocidin expressing Staphylococcus aureus pneumonia managed with extracorporeal membrane oxygenation: experience and outcome. Crit Care Med 2010; 38:2250-3.
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