Methicillin-resistant Staphylococcus aureus-related Septic Pulmonary Embolism and Sacroiliitis Treated with Long-term Linezolid in a Patient with Adult-onset Still's Disease

Yoshiro Horai; Koichi Izumikawa; Satoru Oka; Yoshikazu Nakashima; Takahisa Suzuki; Hideki Nakajima; Shin-ya Kawashiri; Naoki Iwamoto; Kunihiro Ichinose; Mami Tamai; Hideki Nakamura; Tomoki Origuchi; Shigeru Kohno; Atsushi Kawakami

doi:10.2169/internalmedicine.53.1579

CASE REPORTS

Methicillin-resistant Staphylococcus aureus-related Septic Pulmonary Embolism and Sacroiliitis Treated with Long-term Linezolid in a Patient with Adult-onset Still's Disease

Yoshiro Horai, Koichi Izumikawa, Satoru Oka, Yoshikazu Nakashima, Takahisa Suzuki, Hideki Nakajima, Shin-ya Kawashiri, Naoki Iwamoto, Kunihiro Ichinose, Mami Tamai, Hideki Nakamura, Tomoki Origuchi, Shigeru Kohno, Atsushi Kawakami

Author information

Yoshiro Horai
Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
Koichi Izumikawa
Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Japan
Satoru Oka
Department of Nephrology, Nagasaki University Hospital, Japan
Yoshikazu Nakashima
Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
Takahisa Suzuki
Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
Hideki Nakajima
Unit of Translational Medicine, Department of Clinical Neuroscience and Neurology, Nagasaki University, Graduate School of Biomedical Sciences, Japan
Shin-ya Kawashiri
Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
Naoki Iwamoto
Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
Kunihiro Ichinose
Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
Mami Tamai
Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
Hideki Nakamura
Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
Tomoki Origuchi
Unit of Translational Medicine, Department of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
Shigeru Kohno
Department of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Japan
Atsushi Kawakami
Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Japan

Keywords: adult-onset Still's disease, linezolid, septic pulmonary embolism, vancomycin

JOURNAL OPEN ACCESS

2014 Volume 53 Issue 9 Pages 1023-1027

DOI https://doi.org/10.2169/internalmedicine.53.1579

Details

Abstract

We herein report the case of a 21-year-old woman with refractory adult-onset Still's disease who developed central venous catheter-related methicillin-resistant Staphylococcus aureus sepsis during aggressive immunosuppressive therapy. She subsequently experienced septic pulmonary embolism (SPE) and sacroiliitis during treatment with intravenous vancomycin and was successfully treated with long-term oral linezolid therapy. This case suggests that the occurrence of methicillin-resistant Staphylococcus aureus infection in immunosuppressive patients can trigger severe clinical manifestations such as SPE and septic sacroiliitis and that linezolid is suitable for treating such conditions.

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