Life-threatening infection due to community-acquired methicillin-resistant Staphylococcus aureus: case report and review

Eur J Pediatr. 2010 Jan;169(1):47-53. doi: 10.1007/s00431-009-0977-1. Epub 2009 Apr 3.

Abstract

We report an unusual case of serious, multifocal, invasive infection due to community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) in a 10-year-old girl with favorable outcome. The child manifested femoral osteomyelitis, pyomyositis, deep femoral vein thrombosis, pneumonia, encephalopathy, and disturbances of almost all organs. She remained in a critical condition for a week. Fever persisted for 6 weeks and acute phase reactants remained increased for 6 months, necessitating a 7-month antistaphylococcal therapy with a glycopeptide and clindamycin. This led to resolution of infection-associated problems during the subsequent 36 months of follow-up. CA-MRSA strain isolated from the patient harbored both staphylococcal chromosomal cassette type IV (SCCmec type IV) and Panton-Valentine leukocidin genes. A literature review of serious CA-MRSA infections indicated that only a small minority of published cases had favorable outcome.

Publication types

  • Case Reports

MeSH terms

  • Bacterial Proteins / genetics
  • Bacterial Toxins / genetics
  • Child
  • DNA, Bacterial / analysis
  • Exotoxins / genetics
  • Female
  • Follow-Up Studies
  • Humans
  • Leukocidins / genetics
  • Magnetic Resonance Imaging
  • Methicillin Resistance / immunology*
  • Methicillin-Resistant Staphylococcus aureus / genetics
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Penicillin-Binding Proteins
  • Polymerase Chain Reaction
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology*

Substances

  • Bacterial Proteins
  • Bacterial Toxins
  • DNA, Bacterial
  • Exotoxins
  • Leukocidins
  • Panton-Valentine leukocidin
  • Penicillin-Binding Proteins
  • mecA protein, Staphylococcus aureus