Pseudomembranous colitis secondary to methicillin-resistant Staphylococcus aureus (MRSA)

Area of Science:

• Gastroenterology
• Infectious Diseases
• Microbiology

Background:

• A 37-year-old female with type II diabetes and Crohn's disease presented with prolonged gastrointestinal distress.
• The patient had a history of cholecystectomy.

Observation:

• Symptoms included cramping abdominal pain, nausea, emesis, and diarrhea lasting over two weeks.
• Flexible sigmoidoscopy revealed segmental pseudomembranes in the rectum and sigmoid colon.
• Initial Clostridium difficile PCR tests were negative.

Findings:

• Stool culture showed heavy growth of methicillin-resistant Staphylococcus aureus (MRSA) with an absence of normal enteric flora.
• The clinical presentation and food history suggested Staphylococcal food poisoning.

Implications:

• This case highlights the importance of considering alternative pathogens, such as MRSA, in severe gastrointestinal presentations, even when initial tests for common culprits like Clostridium difficile are negative.
• Successful treatment with oral vancomycin demonstrates its efficacy against MRSA-induced enterocolitis.
• Highlights the diagnostic challenges in differentiating infectious colitis.