1. Pediatric Pneumonia Death Caused by
Community-acquired Methicillin-
Resistant Staphylococcus aureus
An article from Japan, entitled Pediatric Pneumonia Death Caused by Community-acquired Methicillin-
Resistant Staphylococcus aureus, describes the capability of the said bacteria in causing fatalities among
children. The strain carries genes for Panton-Valentine leukocidin (PVL) and is mainly associated with skin and
soft tissue infections in young people and also with life-threatening sepsis and community-acquired pneumonia
(preceded by influenza). They illustrated a fatal case of pediatric pneumonia and septic shock from CA-MRSA in
Japan. A 16-month-old, previously healthy boy was admitted to the hospital for fever and shortness of breath on
August 30, 2006. With cold-like symptoms running for 14 days and fever for 2 days, upon admission hordeolum
of the right eyelid and cyanosis were observed. The boy displayed tachycardia (185 bpm), tachypnea (72 cpm),
and hyperthermia (39.8°C). Chest radiography indicated lobar consolidation and pleural effusion on the right
side. Laboratory analysis showed leukocytopenia, thrombocytopenia, elevated C-reactive protein level, and
hypoxemia. Laboratory values of disseminated intravascular coagulation (DIC) were observed: platelet count 121
K/mm3, fibrinogen level 528 mg/dL, fibrin degradation products 37.7 μg/mL, prothrombin time 1.86 INR, and D-
dimer 37.7 μg/mL. The condition was considered septic shock hence the boy was transferred to the PICU. On
day 3, blood culture yielded MRSA; Meropenem therapy was continued to cover possible mixed bacterial
infection. On day 4, computed tomographic examination detected pneumothorax and athelectasis. Meropenem
was changed to flomoxef on the expectation that a possible synergistic effect of flomoxef and vancomycin might
occur. On day 7, the patient was considered to have acute respiratory distress syndrome. A percutaneous
cardiopulmonary support system was used, but in spite of treatment, there was no improvement, and the child
died on day 10 after admission.
The article was relatively crushing considering that it is concerning a young life’s end. The patient I have
taken care of during my latest shift was a 5 year old girl who was diagnosed of PCAP and was by that time
regaining strength, fairly active and casually conversant. She has already been staying at the pediatrics ward for
3 days at the point I handled her. In contrast to the patient in the case considered in the article, my patient has
responded to therapy very well. Moreover, in any case that a bacteria had been the cause of her admitting
diagnosis, the strain was far from being seriously pathogenic compared to the CA-MRSA which cost the life of
that toddler in Japan. My patient had registered vital signs within the normal ranges, very much different from
the Japanese child who had from the start already displayed abnormal vital signs. May have it been because of
disparity in immunity, may have it been because of the difference in age or even in sex, I believe that the
superior factor to be considered in the dissimilarities between the two cases is the cause of their illness. With all
the therapies attempted by the medical team for the young boy and yet with no success, I can conclude that the
CA-MRSA strain was well off non-existent. That even with more medications, more therapies, more attempts, no
more could really be done because of the severity of the harm this microorganism sends off.

2. The article has heightened both my cautiousness and consciousness of everything I take in. Anytime in
the near or far future, I know it would not be easy to be fighting for your life after having acquired an illness
caused by an organism so tiny, unseen by the naked eye. It has stirred me to not belittle sterilization, sanitation,
and the like but instead prioritize even the simple technique of hand hygiene. Life is too short to cut off with a
disease sourced from an unwanted creature which could have been prevented with sanitation. Furthermore, it
is very helpful information to be disseminating to not only CAP patients but also to all people in general. As for
my patient, she would be benefiting much from the same knowledge after an easily understandable
presentation of the case. Presenting it in a not-so-horrifying way would promote active listening and reception.
In order that, afterwards, application of what she has learned would be practiced for years until she grows up
and enjoys a fruitful and or course, healthy life.