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Rare presentation of sepsis caused by necrotizing scalp infection

Katrina Tulla1, Shannon Caesar-Peterson1, Anouchka Coste1

  • 1Department of General Surgery, Wyckoff Heights Medical Center, New York City, NY, USA.

Journal of Surgical Case Reports
|March 25, 2020
PubMed

Insights

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) can cause severe skin infections. This case details a large scalp abscess in an elderly patient, complicated by bacteremia and necrosis, requiring extensive treatment.

Area of Science:

  • Infectious Diseases
  • Dermatology
  • Surgical Pathology

Background:

  • Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is an increasing cause of skin and soft tissue infections.
  • CA-MRSA infections can lead to severe complications, even in atypical locations.

Observation:

  • A 73-year-old female presented with altered mental status.
  • Physical examination revealed two large, fluctuant scalp abscesses.
  • The patient was diagnosed with bacteremia and tissue necrosis.

Findings:

  • The scalp and post-auricular abscesses were treated with intravenous antibiotics and multiple surgical debridements.
  • No calvarial periosteum involvement was noted.
  • Split-thickness skin grafts were utilized for wound closure.

Implications:

  • This case underscores the potential severity of CA-MRSA skin infections, particularly in unusual sites like the scalp.
  • Prompt diagnosis and aggressive management, including surgical intervention, are crucial for favorable outcomes.
  • Highlights the importance of considering CA-MRSA in patients presenting with severe skin and soft tissue infections.
Keywords:
CA-MRSAbacteremiascalpskin graftsoft tissue infection

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