METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) LARYNGITIS: A RARE CAUSE OF DIFFICULT WEANING FROM INVASIVE MECHANICAL VENTILATION.

Clinical Case We admitted a 62 years old patient with acute respiratory failure due to COPD exacerbation. We began empiric antibiotic therapy. Extubation was attempted without success because of an unexpected upper airways’ obstruction, with symptoms such as stridor and retractions, and also difficult reintubation. Fibrobronchoscopy and laryngoscopy revealed whitish plaques lining the glottis, glottis’ edema, vocal cords’ adduction and evidence of synechia. We decided upon tracheotomy. In bronchoaspirated and tracheotomy’s stoma’s specimens we found MRSA colonies. We introduced targeted therapy with teicoplanine, resulted in a favourable outcome.