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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
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Methicillin-resistant Staphylococcus aureus enterocolitis sequentially complicated with septic arthritis: a case

Yukari Ogawa, Takeshi Saraya1, Takashi Koide

  • 1Department of Respiratory Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan. sara@yd5.so-net.ne.jp.

BMC Research Notes
|January 11, 2014
PubMed
Abstract

Insights

This case study details a 74-year-old man with methicillin-resistant Staphylococcus aureus (MRSA) enterocolitis, a rare condition. The findings suggest MRSA enterocolitis can lead to severe complications like septic arthritis.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Methicillin-resistant Staphylococcus aureus (MRSA) enterocolitis is a debated clinical entity with undefined diagnostic criteria.
  • Most reported cases originate from Japan, highlighting a potential regional focus or reporting bias.

Observation:

  • A 74-year-old man presented with severe community-acquired pneumococcal pneumonia, followed by refractory watery diarrhea.
  • Diarrhea resolved with oral vancomycin, and stool analysis revealed abundant leukocytes and dominant MRSA (10^4 CFU/mL).
  • The patient subsequently developed MRSA bacteremia and septic arthritis of the hip.

Findings:

  • Clinical, microbiological, and molecular data confirmed MRSA enterocolitis in this patient.
  • Pulsed-field gel electrophoresis identified all MRSA isolates (stool, blood, synovial fluid, sputum) as belonging to the same clone (ST 764, complex clonal 5) with SCCmec type II.
  • This molecular evidence supports a single-clone, systemic MRSA infection originating from the gut.

Implications:

  • This case provides strong evidence supporting the existence and clinical significance of MRSA enterocolitis.
  • It underscores the potential for MRSA enterocolitis to precipitate invasive MRSA disease, including bacteremia and septic arthritis.
  • Further research is warranted to establish diagnostic criteria and understand the pathogenesis of MRSA enterocolitis.

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