Cavity Forming Pneumonia Due to Staphylococcus aureus Following Dengue Fever

Miyata, Nobuyuki; Yoshimura, Yukihiro; Tachikawa, Natsuo; Amano, Yuichiro; Sakamoto, Yohei; Kosuge, Youko

doi:10.4269/ajtmh.15-0045

Cited by 12 publications

(12 citation statements)

References 16 publications

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“…In the present study, the most common pathogen in the 33 cases of confirmed bacteremia was Escherichia coli , followed by Staphylococcus aureus ( S aureus ), and streptococcus pp. Despite our finding that S aureus was the most commonly reported copathogen, different from that of other reports, [ 23 , 24 ] the present study and other reports [ 25 , 26 ] might indicate the clinical significance of bacterial infections in patients with severe dengue. It should at least emphasize the importance of an early diagnosis of cobacterial infections and prompt antibiotic treatment of patients critically ill with dengue.…”

Section: Discussioncontrasting

confidence: 99%

The outcomes of patients with severe dengue admitted to intensive care units

Chen

Chan

et al. 2016

Medicine

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Outcomes of adult patients with dengue infections requiring intensive care unit (ICU) admissions remain unclear. We assessed the clinical manifestations and prognostic factors of patients critically ill with severe dengue.This retrospective study was done in a tertiary referral hospital with 96 adult ICU beds. All of the patients with laboratory-confirmed severe dengue infections and admitted to the ICU were enrolled between July 31 and November 31, 2015, during the large outbreak period. The medical records of all the recruited patients were reviewed for the following information: age, gender, clinical manifestations, disease severity scores, underlying conditions, laboratory examinations, and outcomes. The primary endpoint was to find the predictors of ICU mortality.During the study period, 4787 patients with dengue infections required ICU admission. One hundred forty-three (2.99%) were critically ill (mean age: 69.7 years). Hypertension (n = 90, 62.9%) and diabetes mellitus (n = 70, 49.0%) were the 2 most common underlying diseases. Eighty critically ill patients (55.9%) had cobacterial infections, and 33 had cobacteremia. The hematologic system failed most often, followed by thoracic and cardiovascular systems. Fever was the most common presentation (n = 112; 78.3%), followed by anorexia (n = 47; 32.9%) and abdominal pain (n = 46; 32.2%). Overall, 33 patients died (mortality rate: 23.1%). Multivariate analysis showed that ICU mortality was significantly associated with lower Glasgow Coma Scale (GCS) scores, lower platelet counts before ICU discharge, and more organ failures.The number of severe dengue patients who require ICU admission remains high. The mortality rate was associated with lower GCS scores, lower platelet counts, and more organ failures. In addition, more than half of the critically ill dengue patients had comorbid bacterial infections.

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Section: Discussioncontrasting

confidence: 99%

The outcomes of patients with severe dengue admitted to intensive care units

Chen

Chan

et al. 2016

Medicine

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“…Dengue patients are vulnerable to secondary bacterial infections due to leucopenia (especially neutropenia), impairment of antigen-presenting cells’ functions, reduction of the phagocytic and migratory capacities of macrophages, impairment of the interferon signaling pathway, impairment of the integrity of skin barrier against bacteria and other transient changes in the immune system caused by dengue virus [ 2 , 8 , 9 , 17 , 20 , 21 ]. Increased capillary leakage of DHF is also speculated to favor bacterial infections [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Concurrent methicillin-resistant Staphylococcus aureus septicemia and pyomyositis in a patient with dengue hemorrhagic fever: a case report

et al. 2018

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BackgroundConcurrent presence of dengue hemorrhagic fever (DHF), tropical pyomyositis and septicemia due to methicillin-resistant Staphylococcus aureus (MRSA) in a previously healthy person has never been reported. These three conditions even individually are potentially fatal. “Here we describe a case of a patient contracting dengue and developing DHF along with concurrent pyomyositis likely to be due to MRSA, leading to MRSA septicemia with abscesses formed by MRSA”.Case presentationA 44-year old previously healthy Sinhalese man presented on day 3 of the illness with fever, headache, arthralgia and myalgia and watery loose stools. His pulse rate was 76/min, blood pressure was 110/80 mmHg, while cardiovascular, respiratory and abdomen examination findings were unremarkable. The test for the dengue NS1 antigen was positive on the same day. We have diagnosed dengue and started managing him symptomatically as per the current national guidelines. The patient developed DHF with bilateral pleural effusion and ascitis. On the day 5 he developed severe myalgia, tenderness and non pitting edema of lower limbs especially in the thighs. His creatine kinase levels were high and an ultrasound scan confirmed myositis of both thighs. We suspected myositis due to dengue but investigated for possible simultaneous sepsis as well. On day 9 his blood culture became positive for MRSA. Considering the sensitivity of the bacteria intravenous vancomycin and ciprofloxacin was administered for 21 days. He developed a small abscess at the site of the first intravenous access and a large one above the ankle on the left. On day 12 the latter was drained and the pus culture yielded MRSA sensitive to the same antibiotics. The rapid test for dengue IgM was negative initially but later a positive MAC-ELISA test entrenched dengue infection. After improvement he was sent home on day 33 of the illness. He has developed two other abscesses in the proximity of the drained one and they were drained on day 57. The patient recovered.ConclusionsWhen dengue patients develop symptoms and signs of myositis, prompt investigations for pyomyositis and the treatment can save lives.

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“…Some patients might have both pneumonia and dengue and this problem might be difficult for diagnosis. The Staphylococcus pneumonia is reported for concurrence with dengue [4][5] . Cavity lesion is generally observed in those dengue with concurrent Staphylococcus pneumonia.…”

Section: Dengue and Pneumoniamentioning

confidence: 94%

Pneumonia in Tropical Arbovirus Infection: An Issue in Tropical Respiratory Medicine

Wiwanitkit

2018

Journal of Respiratory Research

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The tropical arbovirus infection is the present public health in several countries. The clinical manifestation of tropical arbovirus infection is various, however, the common presentation is the acute febrile illness. The respiratory problem relating to tropical arbovirus infection is very interesting. In the present editorial the clinical interrelationship between pneumonia and important tropical arbovirus infection is summarized and discussed.

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Cavity Forming Pneumonia Due to Staphylococcus aureus Following Dengue Fever

Cited by 12 publications

References 16 publications

The outcomes of patients with severe dengue admitted to intensive care units

The outcomes of patients with severe dengue admitted to intensive care units

Concurrent methicillin-resistant Staphylococcus aureus septicemia and pyomyositis in a patient with dengue hemorrhagic fever: a case report

Pneumonia in Tropical Arbovirus Infection: An Issue in Tropical Respiratory Medicine

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