Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Sep 9, 2021; 10(5): 301-309
Published online Sep 9, 2021. doi: 10.5492/wjccm.v10.i5.301
Near-fatal Panton-Valentine leukocidin-positive Staphylococcus aureus pneumonia, shock and complicated extracorporeal membrane oxygenation cannulation: A case report
Joshua Cuddihy, Shreena Patel, Nabeela Mughal, Christopher Lockie, Richard Trimlett, Stephane Ledot, Nicholas Cheshire, Ajay Desai, Suveer Singh
Joshua Cuddihy, Magill Department for Anaesthesia, Critical Care and Pain Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London SW10 9NH, United Kingdom
Joshua Cuddihy, Department of Surgery and Cancer, Imperial College London, London SW7 2BU, United Kingdom
Shreena Patel, Chelsea and Westminster Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London SW10 9NH, United Kingdom
Shreena Patel, Warwick Medical School, Warwick University, Warwick CV4 7HL, United Kingdom
Nabeela Mughal, Microbiology and Infectious Diseases, Chelsea and Westminster Hospital NHS Foundation Trust, London SW10 9NH, United Kingdom
Nabeela Mughal, Suveer Singh, Imperial College London, Imperial College London, London SW7 2BU, United Kingdom
Christopher Lockie, Intensive Care Unit, Chelsea and Westminster Hospital NHS Foundation Trust, London SW10 9NH, United Kingdom
Richard Trimlett, Cardiac Surgery, Royal Brompton and Harefield NHS Foundation Trust, London SW3 6NP, United Kingdom
Stephane Ledot, Suveer Singh, Adult Intensive Care Unit, Royal Brompton and Harefield NHS Foundation Trust, London SW3 6NP, United Kingdom
Nicholas Cheshire, Vascular Surgery, Royal Brompton and Harefield NHS Foundation Trust, London SW3 6NP, United Kingdom
Ajay Desai, Paediatric Intensive Care Unit, Royal Brompton and Harefield NHS Foundation Trust, London SW3 6NP, United Kingdom
Suveer Singh, Department of Intensive Care Medicine, Chelsea and Westminster Hospital, London SW10 9NH, United Kingdom
Author contributions: Cuddihy J, Singh S, Lockie C, Trimlett R, Cheshire N, Ledot S and Desai A provided clinical care for the patient on Adult Intensive Care Units; Cuddihy J and Patel S contributed to writing the original draft; Cuddihy J, Mughal N, Singh S, Lockie C, Trimlett R, Cheshire N, Ledot S and Desai A contributed to reviewing and editing the manuscript; Mughal N performed the infectious disease consultation; all authors issued final approval for the version to be submitted.
Informed consent statement: Written informed consent was obtained from the patient and her parents to publish this case report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Suveer Singh, BSc, MBBS, PhD, EDIC, FHEA, FFICM, FRCP, Consultant Physician-Scientist, Doctor, Lecturer, Departments of Adult Intensive Care Medicine, Royal Brompton Hospital and Chelsea & Westminster Hospital, Imperial College London, 369 Fulham Road, London SW10 9NH, United Kingdom. suveer.singh@imperial.ac.uk
Received: April 6, 2021
Peer-review started: April 6, 2021
First decision: June 5, 2021
Revised: June 17, 2021
Accepted: August 24, 2021
Article in press: August 24, 2021
Published online: September 9, 2021
Processing time: 154 Days and 20.8 Hours
Core Tip

Core Tip: We present a case of profound vasoplegic shock and acute respiratory distress syndrome in a healthy adolescent after a mild prodromal illness. Acute cardiorespiratory failure persisted despite aggressive resuscitation and vasoactive support. Cardiac arrest and complicated extracorporeal membrane oxygenation (ECMO) cannulation necessitated emergency venoarterial-ECMO during cardiopulmonary resuscitation. Early respiratory samples confirmed H3N2 influenza and Panton-Valentine leukocidin-Staphylococcus aureus (PVL-SA) pneumonia: A rare and serious manifestation of the PVL-SA, usually associated with less severe skin and soft-tissue infections. The patient’s ultimate survival and recovery depended on the extraordinary interplay and rapid utilisation of multidisciplinary teams which we highlight for the benefit of other services to ensure optimal outcomes, even against the odds.