Pneumonia, meningitis, and endocarditis caused by Staphylococcus aureus in a patient living with HIV/AIDS

Authors

  • Isabela Della Torre Oliveira Instituto de Infectologia Emílio Ribas
  • Murillo Barbosa Crivillari Instituto de Infectologia Emílio Ribas
  • Raquel Cordeiro Instituto de Infectologia Emílio Ribas
  • Isabella Versiani Martins Rocha Instituto de Infectologia Emílio Ribas
  • Leonardo Carrara Matsuura Instituto de Infectologia Emílio Ribas
  • Matheus Costa Freitas Instituto de Infectologia Emílio Ribas

DOI:

https://doi.org/10.5935/2764-734X.e20250664

Keywords:

Methicillin-Resistant Staphylococcus Aureus, Pneumonia, Meningitis, Bacterial, Endocarditis, AIDS

Abstract

Invasive Staphylococcus aureus infections, in particular those caused by methicillin-resistant strains (MRSA), are a major clinical challenge, especially in immunocompromised individuals. Patients living with HIV/AIDS are at increased risk of MRSA colonization and infection with potentially severe and multisystemic clinical presentations. This report describes the case of a 43-year-old man who initially presented with skin lesions and then developed severe systemic pneumonia, meningitis, and infective endocarditis caused by MRSA. The patient was treated with prolonged antibiotic therapy and had a favorable outcome after 2 months of hospitalization.

References

Utay NS, Roque A, Timmer JK, Morcock DR, DeLeage C, Somasunderam A, et al. MRSA Infections in HIV-Infected People Are Associated with Decreased MRSA-Specific Th1 Immunity. PLoS Pathog. 2016 Apr 19;12(4):e1005580. DOI: 10.1371/journal.ppat.1005580

Nguyen MH, Kauffman CA, Goodman RP, Squier C, Arbeit RD, Singh N, et al. Nasal carriage of and infection with Staphylococcus aureus in HIV-infected patients. Ann Intern Med. 1999 Feb 2;130(3):221–5. DOI: 10.7326/0003-4819-130-3-199902020-00026

Sabbagh P, Riahi SM, Gamble HR, Rostami A. The global and regional prevalence, burden, and risk factors for methicillin-resistant Staphylococcus aureus colonization in HIV-infected people: A systematic review and meta-analysis. Am J Infect Control. 2019 Mar;47(3):323–33. DOI: 10.1016/j.ajic.2018.06.023

Cole J, Popovich K. Impact of community-associated methicillin resistant Staphylococcus aureus on HIV-infected patients. Curr HIV/AIDS Rep. 2013 Sep;10(3):244–53. DOI: 10.1007/s11904-013-0161-0

Ferreira DC, Silva GR, Cavalcante FS, Carmo FL, Fernandes LA, Moreira S, et al. Methicillin-resistant Staphylococcus aureus in HIV patients: risk factors associated with colonization and/or infection and methods for characterization of isolates – a systematic review. Clinics (Sao Paulo). 2014 Nov;69(11):770–6. DOI: 10.6061/clinics/2014(11)11

Liesenborghs L, Verhamme P, Vanassche T. Staphylococcus aureus, master manipulator of the human hemostatic system. J Thromb Haemost. 2018 Mar;16(3):441–54. DOI: 10.1111/jth.13928

Singh V, Phukan UJ. Interaction of host and Staphylococcus aureus protease-system regulates virulence and pathogenicity. Med Microbiol Immunol. 2019 Oct;208(5):585–607. DOI: 10.1007/s00430-018-0573-y

Yang C, Robledo-Avila FH, Partida-Sanchez S, Montgomery CP. α-Hemolysin-mediated endothelial injury contributes to the development of Staphylococcus aureus-induced dermonecrosis. Infect Immun. 2024 Aug;92(8):e0013324. DOI: 10.1128/iai.00133-24

Chandler DJ, Walker SL. HIV and skin infections. Clin Dermatol. 2024 Mar/Apr;42(2):155–68. DOI: 10.1016/j.clindermatol.2023.12.005

Takigawa Y, Fujiwara K, Saito T, Nakasuka T, Ozeki T, Okawa S, et al. Rapidly Progressive Multiple Cavity Formation in Necrotizing Pneumonia Caused by Community-acquired Methicillin-resistant Staphylococcus aureus positive for the Panton-Valentine Leucocidin Gene. Intern Med. 2019 Mar;58(5):685–91. DOI: 10.2169/internalmedicine.1454-18

Myint T, Leedy N, Villacorta Cari E, Wheat LJ. HIV-Associated Histoplasmosis: Current Perspectives. HIV AIDS (Auckl). 2020 Mar 19;12:113–25. DOI: 10.2147/HIV.S185631

Delgado V, Marsan NA, Waha S, Bonaros N, Brida M, Burri H, et al. 2023 ESC Guidelines for the management of endocarditis. Eur Heart J. 2023;44(39):3948–4042. DOI: 10.1093/eurheartj/ehad193

Rivera K, Viles D, Zielonka M, Izurieta C, Martínez TR, Menéndez D. Austrian syndrome: Resurgence of an old and deadly triad. J Intensive Med. 2023 Sep;4(2):261–4. DOI: 10.1016/j.jointm.2023.06.006

Pandey N, Khan Y, Okobi T, Uhomoibhi D, Abolurin A, Akinlabi OA, et al. Austrian Syndrome: The Forgotten Triad of a Complex Condition in an Antibiotic Era. Cureus. 2022 Dec;14(12):e32106. DOI: 10.7759/cureus.32106

Austrian R. The syndrome of pneumococcal endocarditis, meningitis and rupture of the aortic valve. Trans Am Clin Climatol Assoc. 1956–1957;68:40–7; discussion 48–50.

Published

2025-08-25

How to Cite

Oliveira, I. D. T., Crivillari, M. B., Raquel Cordeiro, Rocha, I. V. M., Matsuura, L. C., & Freitas, M. C. (2025). Pneumonia, meningitis, and endocarditis caused by Staphylococcus aureus in a patient living with HIV/AIDS. Infections in Evidence, 4, e20250664. https://doi.org/10.5935/2764-734X.e20250664

Issue

Section

Case Reports