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Volume 12, Number 6—June 2006
Research

Severe Community-acquired Pneumonia Due to Staphylococcus aureus, 2003–04 Influenza Season

Jeffrey C. Hageman*Comments to Author , Timothy M. Uyeki*, John S. Francis†, Daniel B. Jernigan*, J. Gary Wheeler‡, Carolyn B. Bridges*, Stephen J. Barenkamp§, Dawn M. Sievert¶, Arjun Srinivasan*, Meg C. Doherty†, Linda K. McDougal*, George E. Killgore*, Uri A. Lopatin#, Rebecca Coffman**, J. Kathryn MacDonald††, Sigrid K. McAllister*, Gregory E. Fosheim*, Jean B. Patel*, and L. Clifford McDonald*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Johns Hopkins Medical Institutions, Baltimore, Maryland, USA; ‡University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas, USA; §Saint Louis University School of Medicine, Saint Louis, Missouri, USA; ¶Michigan Department of Community Health, Lansing, Michigan, USA; #National Institutes of Health, Bethesda, Maryland, USA; **Oklahoma State Department of Health, Oklahoma City, Oklahoma, USA; ††Washington State Department of Health, Shoreline, Washington, USA

Main Article

Table 1

Demographic and clinical characteristics of cases of Staphylococcus aureus community-acquired pneumonia associated with influenzalike illness, influenza season 2003–04*

Characteristic No. (%), N = 17
Median age, y (range) 21 (3 mo–62 y)
Sex, male 8 (47)
Race
White 10 (59)
Black 7 (41)
Underlying disease† 5 (29)
MRSA risk factors‡ 4 (24)
Documented influenza vaccination 1 (6)
Evidence of influenza infection
Laboratory-confirmed 12 (71)§
Rapid antigen test 10 (59)
Paired serology 2 (12)
Fluorescent antibody staining 2 (12)
Clinical symptoms
Cough 14 (82)
Myalgias 9 (53)
Sore throat 6 (35)
Headache 6 (35)
Shortness of breath 5 (29)
Rigors 4 (24)
Clinical signs
Temperature >38°C 12/13 (92)
Hypotension (systolic blood pressure <90 mm Hg) 12/13 (93)
Normal or elevated leukocyte count† (>3,500/mm3) 12/16 (75)
Median leukocyte count (range) 16,500 mm3 (6,000–295,000)
Leukopenia (<3,500/mm3) 4/16 (25)
Thrombocytopenia (<150,000/mm3) 6/16 (38)
Radiologic documentation of pneumonia¶#
Lobar 3/16 (19)
Multiple lobe involvement 4/16 (25)
Diffuse/patchy infiltrates 6/16 (38)
Effusions/empyema 5/16 (31)
Cavitation/necrosis 4/16 (25)

*MRSA, methicillin-resistant S. aureus.
†One each of diabetes, multiple sclerosis, prune belly syndrome, cystic fibrosis, eczema.
‡Hospitalization, dialysis, surgery, or residence in a long-term care facility in the previous year; ever having an MRSA infection; and presence of percutaneous device or catheter at time of culture.
§One patient had influenza infection confirmed by all methods.
¶One patient died on arrival at the hospital. #Not mutually exclusive.

Main Article

Page created: January 04, 2012
Page updated: January 04, 2012
Page reviewed: January 04, 2012
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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