MRSA pneumonia is cause for concern, because of the potential for necrotizing pneumonia, i.e. flesh-eating pneumonia.
Pneumonia is an infection of the lung’s microscopic air sacs, called alveoli. Alveoli are responsible for oxygen exchange; therefore, infected alveoli are unable to provide the body with oxygen.
- MRSA pneumonia is cause for concern, because of the potential for necrotizing pneumonia, i.e. flesh-eating pneumonia.
- In necrotizing pneumonia, flesh-eating MRSA bacteria devour and permanently destroy lung tissue.
- MRSA bacteria can then take refuge in the dead or necrotic tissue where it is difficult for antibiotics to penetrate.
- Cough and fever are the most common symptoms, although they are not always present.
- Atypical symptoms are more common in the very young or elderly. These include:
- Abdominal pain
- Other symptoms may include weakness, body aches and fatigue.
The diagnosis of pneumonia is determined clinically via the history and physical, often with the aid of a chest X-ray.
- Auscultation or listening to the lungs with a stethoscope is a necessity; however, not all pneumonias can be detected by auscultation alone.
- A chest X-ray is helpful in many patients. This includes patients where the diagnosis is uncertain, or where it is important to know the extent of the pneumonia. Situations where a chest X-ray may be helpful include:
- Pneumonia is suspected; however, auscultation is not conclusive.
- Pneumonia is diagnosed per auscultation; however, the patient presents several days into the illness and you want to determine the extent of the pneumonia.
- Critically ill patients.
- Very young or elderly patients.
- Patients that present with atypical symptoms – see above under clinical presentation.
- Sputum (phlegm) cultures are rarely collected, because:
- Sputum is difficult to obtain. The sputum sample needs to originate from deep within the lung tissue via a deep cough or mechanical suction.
- Sputum often becomes contaminated with mouth flora (bacteria) during the collection process; therefore, the results are difficult to interpret. Mouth flora are non-infectious bacteria that normally live in the mouth.
- Blood cultures may be obtained in critically ill patients, or in those not responding to treatment. A sample of blood is sent to the lab fortesting. Success enables you to know the exact bacteria causing the infection, and which antibiotics will best treat the infection.