Adult Empyema Caused by Refractory Methicillin-Resistant Staphylococcus aureus Treated Using Linezolid as Salvage Therapeutic Option: A Report of Two Cases
Abstract
Background: The pathogenesis and treatment of pulmonary lesions caused by methicillin-resistant Staphylococcus aureus (MRSA) infection have been unclear because MRSA has usually been considered a colonizer.
Case series: Two adult cases of MRSA empyema were treated using linezolid (LZD) because they were refractory to the glycopeptides vancomycin (VCM) and teicoplanin (TEIC). Case 1 was a 50-year-old man with a history of lung cancer and pneumothorax who was admitted with pulmonary empyema with a severe dry cough. MRSA empyema was diagnosed because only MRSA was detected by video-assisted thoracoscopy (VATS) from his effusions. He was initially treated using VCM for 10 days, but his inflammatory markers and condition did not so improve; therefore, VCM was switched to LZD. His condition improved with LZD for 14 days. Case 2 was a 77-year-old man with pharyngeal cancer who was admitted with respiratory failure. He was diagnosed with MRSA empyema because only MRSA was detected from his pleural effusions on pleural drainage. He received a TEIC drip infusion for 10 days, but his respiratory status did not so improve; therefore, his treatment was switched to LZD. His condition improved with LZD for 14 days.
Conclusion: MRSA empyema was diagnosed in these two cases because only MRSA was detected from pleural effusions. Both patients finally improved following the switch from glycopeptide antibiotics to LZD. These findings suggest MRSA as the true cause of the infections and that…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Ferulic acid regulates the AKT/GSK-3β/CRMP-2 signaling pathway in a middle cerebral artery occlusion animal model
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
- Novel Pharmacokinetic/Pharmacodynamic Parameters Quantify the Exposure–Effect Relationship of Levofloxacin against Fluoroquinolone-Resistant Escherichia coli
- Neuroprotective Effects of Epicatechin against Oxidative Stress-Induced Cognitive Impairment: A Systematic Review and Meta-Analysis
- Photochemical behavior of levofloxacin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.