Fatal septic shock due to PVL-positive Staphylococcus aureus necrotizing pneumonia: autopsy findings and systematic review of the literature.
Jessika Camatti, Anna Laura Santunione, Rossana Cecchi et al.
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Case in brief
A previously healthy 58-year-old man presented with acute respiratory symptoms and quickly progressed to severe respiratory failure and septic shock, leading to death within 24 hours of hospital admission. Forensic autopsy revealed bilateral necrotizing hemorrhagic bronchopneumonia, and molecular analysis confirmed the presence of Panton-Valentine leukocidin (PVL)-positive Staphylococcus aureus. Blood cultures and bronchoalveolar lavage also identified methicillin-susceptible S. aureus.
What made this case unusual
The case highlights a distinctive clinicopathological pattern of necrotizing and hemorrhagic pneumonia associated with PVL-positive S. aureus, characterized by rapid clinical deterioration and high mortality.
Diagnostic / clinical pearl
Clinicians should be aware that PVL-positive Staphylococcus aureus can lead to rapidly progressive necrotizing pneumonia, which may present with acute respiratory failure and septic shock.
Why it matters
Understanding the aggressive nature of PVL-positive S. aureus infections is crucial for timely diagnosis and management, particularly in cases of sudden respiratory decline.