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Lymphocele Containing Staphylococcus lugdunensis
Dinesh Keerty1, Manoj Das2, Timothy N Hembree1
1Internal and Hospital Medicine, Moffitt Cancer Center, Tampa, USA.
Abstract:
Staphylococcus species are a leading cause of community-acquired bacteremia. Of them, the most serious cause of mortality is from methicillin-resistant Staphylococcus aureus, with mortality rates as high as 40%. Another Staphylococcus species that has been noted to cause equal levels of infection and mortality is Staphylococcus lugdunensis (S. lugdunensis). It can cause harmless skin infections to life-threatening endocardial complications. We would like to report a rare presentation of S. lugdunensis bacteremia from a lymphocele that developed post surgery. An 80-year-old male presented to the emergency department with complaints of abdominal pain and fevers. Cultures of lymphocele fluid grew S. lugdunensis. A computed tomography of the abdomen and pelvis with contrast showed the presence of a large lymphocele. S. lugdunensis is a coagulase-negative staphylococci normally known to be a skin colonizer. Over the years, it has shown to cause a wide variety of infections especially involving prosthetic joints and heart valves. S. lugdunensis has been noted to be highly susceptible to penicillins, such as oxacillin, erythromycin, linezolid and a wide a variety of other antibiotics. S. lugdunensis produces a biofilm that makes treatment challenging even with susceptible antibiotics. However, the data on S. lugdunensis is growing as more case reports are being published in regards to source and susceptibilities.
Insights
Staphylococcus lugdunensis can cause serious infections, including bacteremia originating from post-surgical lymphoceles. This rare case highlights the need for awareness of S. lugdunensis as a significant pathogen.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Medicine
Background:
- Staphylococcus species are a major cause of bloodstream infections.
- Methicillin-resistant Staphylococcus aureus (MRSA) is associated with high mortality.
- Staphylococcus lugdunensis (S. lugdunensis) is increasingly recognized for causing severe infections.
Observation:
- A rare case of S. lugdunensis bacteremia originating from a post-surgical lymphocele is reported.
- An 80-year-old male presented with abdominal pain and fever, with S. lugdunensis identified in lymphocele fluid.
- Imaging confirmed a large lymphocele as the source of infection.
Findings:
- S. lugdunensis, a coagulase-negative staphylococci, can cause diverse infections beyond skin colonization.
- The pathogen has been linked to serious conditions like prosthetic joint infections and endocarditis.
- Despite susceptibility to many antibiotics, S. lugdunensis forms biofilms, complicating treatment.
Implications:
- This case expands the known spectrum of S. lugdunensis infections.
- Increased reporting of S. lugdunensis cases is crucial for understanding its clinical behavior and antimicrobial susceptibilities.
- Awareness of S. lugdunensis bacteremia from unusual sources like lymphoceles is important for timely diagnosis and management.
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