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Experimental Endocarditis Model of Methicillin Resistant Staphylococcus aureus MRSA in Rat
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Methicillin resistant Staphylococcus aureus infective endocarditis presenting as neutrophilic meningoencephalitis

Tushar Bajaj1, Anthony Karapetians1, Natalie Karapetians1,2

  • 1Department of Medicine, UCLA - Kern Medical, Kern Medical Center, Bakersfield, CA, USA.

AME Case Reports
|March 25, 2020
PubMed

Insights

Staphylococcus aureus infective endocarditis (IE) in a patient with a pacemaker presented with altered mental status and fever. Prompt treatment with antibiotics and device management led to recovery.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Infective endocarditis (IE) caused by Staphylococcus aureus is a serious condition often linked to intravenous drug use or infected cardiac devices.
  • Patients commonly exhibit non-specific symptoms such as fever and malaise, potentially delaying diagnosis.

Observation:

  • A 53-year-old female presented with altered mental status, fever, tachycardia, and back pain, requiring intubation and lumbar puncture.
  • Cerebrospinal fluid analysis showed neutrophil-predominant leukocytosis, and blood cultures identified methicillin-resistant Staphylococcus aureus (MRSA).

Findings:

  • Chest X-ray revealed pulmonary congestion and a pacemaker. Transesophageal echocardiogram (TEE) identified a vegetation on the pacemaker's atrial lead.
  • The infection originated from a peripacemaker pus pocket, a complication two months post-implantation.

Implications:

  • This case highlights the importance of considering IE in patients with pacemakers presenting with systemic symptoms and neurological changes.
  • Successful management involved source control (pacemaker management) and appropriate antibiotic therapy (ceftriaxone and vancomycin).
Keywords:
Methicillin resistant Staphylococcus aureus (MRSA)infective endocarditis (IE)intracardiac devicepacemaker

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