Fulminant arterial vasculitis as an unusual complication of disseminated staphylococcal disease due to the emerging CC1 methicillin-susceptible Staphylococcus aureus clone: a case report

Charles Vidal (1) , Florence Moulin (2) , Xavier Nassif (1) , Louise Galmiche (3) , Delphine Borgel (4) , Alain Charbit (5) , Capucine Picard (6, 7) , Jean-Paul Mira (8, 9) , Olivier Lortholary (10) , Anne Jamet (1, 5) , Julie Toubiana (9, 11)

1 Department of Microbiology [Paris]
2 Department of Pediatric Intensive Care Unit [Paris]
3 Pathology Department [Paris]
4 Department of Hematology [Paris]
5 INEM - UM 111 (UMR 8253 / U1151) - Institut Necker Enfants-Malades
6 Center for the Study of Primary Immunodeficiencies [Paris]
7 Equipe Inserm U1163 - Human genetics of infectious diseases: Complex predisposition
8 Medical Intensive Care Unit [Paris]
9 [Institut Cochin] Departement Infection, immunité, inflammation
10 Department of Infectious Diseases and Tropical Medicine [Paris]
11 Département de Pédiatrie et maladies infectieuses [CHU Necker]

BACKGROUND: Staphylococcus aureus has emerged as a leading cause of invasive severe diseases with a high rate of morbidity and mortality worldwide. The wide spectrum of clinical manifestations and outcome observed in staphylococcal illness may be a consequence of both microbial factors and variability of the host immune response. CASE PRESENTATION: A 14-years old child developed limb ischemia with gangrene following S. aureus bloodstream infection. Histopathology revealed medium-sized arterial vasculitis. The causing strain belonged to the emerging clone CC1-MSSA and numerous pathogenesis-related genes were identified. Patient's genotyping revealed functional variants associated with severe infections. A combination of virulence and host factors might explain this unique severe form of staphylococcal disease. CONCLUSION: A combination of virulence and genetic host factors might explain this unique severe form of staphylococcal disease.

Mots clés: Case report; Genetic susceptibility; Polymorphism; S. aureus; Virulence; Vasculitis; Sepsis

Domaines: Maladies infectieuses; Génétique

Charles Vidal, Florence Moulin, Xavier Nassif, Louise Galmiche, Delphine Borgel, et al.. Fulminant arterial vasculitis as an unusual complication of disseminated staphylococcal disease due to the emerging CC1 methicillin-susceptible Staphylococcus aureus clone: a case report. BMC Infectious Diseases, 2019, 19 (1), pp.302. ⟨10.1186/s12879-019-3933-3⟩. ⟨inserm-02285428⟩