Pneumonie à Staphylococcus aureus : quand faut-il l'évoquer et comment la traiter ?

Staphylococcus aureus is a rare cause of community-acquired pneumonia. However, methicillin resistant S. aureus (MRSA), usually known as a nosocomial pathogen, has emerged as a cause of community-acquired necrotising pneumonia in young healthy patients without classic health-care-associated risk factors. Community-onset necrotising pneumonia due to CA-MRSA is now recognised as an emerging clinical entity (it still rarely described in France) with distinctive clinical features and substantial morbidity and mortality. A viral prodrome (e.g., influenza or influenza-like illness) followed by acute onset of shortness of breath, sepsis, and haemoptysis is the most frequent clinical presentation. Clinicians had to be aware of this cause of community-acquired pneumonia. Indeed in such patients treatment of community-acquired pneumonia should include an appropriate antibiotic treatment to cover MRSA and to decrease toxin production. In some cases, the adjunctive use of intravenous immunoglobulin may be indicated.