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Missed epidural brain abscess after furunculosis
1Department of Emergency Medicine, Eastern Virginia Medical School, Norfolk, VA 23507, USA. brucelo1@yahoo.com
The American Journal of Emergency Medicine
|April 16, 2008
Summary
Community-associated methicillin-resistant Staphylococcus aureus (ca-MRSA) causes skin infections and can lead to invasive conditions. A case highlights the importance of considering ca-MRSA in invasive infections, even in brain abscesses, to ensure timely diagnosis and treatment.
Area of Science:
- Infectious Diseases
- Microbiology
- Neurology
Background:
- Community-associated methicillin-resistant Staphylococcus aureus (ca-MRSA) is a significant pathogen.
- ca-MRSA is frequently associated with cutaneous skin infections.
- Invasive infections, including endocarditis, pneumonia, and necrotizing fasciitis, have been linked to ca-MRSA.
Observation:
- A case of a missed epidural brain abscess caused by ca-MRSA is presented.
- The patient had a recent history of furunculosis.
- A lumbar puncture was performed for meningitis workup prior to a head CT scan.
Findings:
- The case underscores the potential for ca-MRSA to cause serious invasive infections beyond skin.
- Delayed diagnosis of the brain abscess due to missed ca-MRSA was a critical issue.
- The diagnostic pathway highlights potential pitfalls in invasive infection workups.
Implications:
- Physicians must maintain a high index of suspicion for ca-MRSA in invasive infections.
- Prompt head imaging is crucial in patients with suspected central nervous system involvement and risk factors for ca-MRSA.
- Early consideration of ca-MRSA can prevent severe complications and improve patient outcomes.
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