Pneumonia caused by coagulase - positive methicillin - resistant S. aureus: A perplexing case

Introduction. S. aureus is one of the most omnipresent and dangerous human pathogens, which main characteristic is to produce the enzyme coagulase. This characteristic serves to identify and assess pathogenicity. In addition to skin infections, endocarditis, osteomyelitis and infectious arthritis, it is a common cause of pneumonia in both, children and adults. Case report. We described a case of 65 years old woman with dry cough and malaise with patchy areas of consolidation on chest X-ray and ground-glass opacity with bronchial wall thickening and unilateral mediastinal lymphadenopathy on chest CT. MRSA was isolated from bronchoalveolar aspirate taken through bronchoscopy. The woman was empirically treated with azithromycin, and based on the antibiogram findings; azithromycin was replaced by meropenem after which her health improved. Conclusion. We presented a rare case of pneumonia with unconvincing symptomatology, laboratory and radiological findings. In the future, it is necessary to pay more attention to such cases, especially to the use of antibiotics to which staphylococci are increasingly developing resistance.