Related Experiment Video
Updated: Sep 26, 2025
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Methicillin-resistant Staphylococcus aureus enterocolitis in a 16-month-old boy: a case report
Christopher Loerke1, Heather Liebe2, Catherine J Hunter3
1The University of Oklahoma College of Medicine, 800 Stanton L Young Blvd, Oklahoma City, OK, 73117, USA.
Background:
Methicillin-resistant Staphylococcus aureus enterocolitis is a rare disease that typically affects immunocompromised adults. Most cases of pediatric enterocolitis are caused by Gram-negative bacteria, Gram-positive Clostridiodes difficile, or viruses. This is the first published case report of a toddler with methicillin-resistant Staphylococcus aureus enterocolitis.
Case Presentation:
A 16-month-old non-Hispanic White boy with no past medical or psychosocial history initially presented to the emergency room with abdominal pain and emesis. Past family history was pertinent only for his father having a history of constipation. He was diagnosed with intussusception and underwent successful contrast reduction on hospital day 0. The following day, the patient had recurrent symptoms and a repeat contrast enema showed no evidence of recurrent intussusception. A computed tomography scan was obtained, which was concerning for possible recurrence with compromised bowel. He was taken to the operating room for operative reduction and underwent an ileocecetomy with primary handsewn end-to-end anastomosis. His postoperative course was complicated by an anastomotic leak on hospital day 6 necessitating reoperation and creation of an end ileostomy with mucous fistula. He received intravenous metronidazole, ceftriaxone, and ceftazidime antibiotics during his hospital course. On postoperative day 12, the patient developed a sudden increase in ileostomy output, and stool cultures were obtained. His symptoms persisted despite diet modifications, stopping antibiotics, and initiating loperamide. Three days later, stool cultures resulted negative for Escherichia coli, Salmonella, Shigella, Campylobacter species, and Clostridiodes difficile but were positive for methicillin-resistant Staphylococcus aureus. The patient was started on a 10-day course of oral vancomycin and discharged home in good condition 4 days later. After 12 weeks, the patient underwent reversal of the ostomy and is doing well at the 1 month postoperative follow-up, now 5 months from his initial surgery.
Conclusions:
To our knowledge, this is the first published report of a toddler being diagnosed with methicillin-resistant Staphylococcus aureus enterocolitis. Because methicillin-resistant Staphylococcus aureus enterocolitis is rare and has overlapping symptoms with more common gastrointestinal pathologies, it is often misdiagnosed. When a patient presents with diarrhea or high ostomy output along with fecal cultures negative for Clostridiodes difficile and other common pathogenic agents, methicillin-resistant Staphylococcus aureus should be considered.
Insights
This case report details the first toddler diagnosed with methicillin-resistant Staphylococcus aureus enterocolitis, a rare condition often misdiagnosed. Early consideration of MRSA is crucial when common pathogens are ruled out.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) enterocolitis is rare, primarily affecting immunocompromised adults.
- Pediatric enterocolitis typically involves Gram-negative bacteria, Clostridiodes difficile, or viruses.
- This report presents the first documented case of MRSA enterocolitis in a toddler.
Observation:
- A 16-month-old toddler presented with symptoms initially diagnosed as intussusception, requiring surgical intervention.
- Postoperatively, the patient developed an ileostomy leak and persistent diarrhea despite standard treatments.
- Stool cultures were positive for MRSA after initial negative results for common enteric pathogens.
Findings:
- The toddler was successfully treated with oral vancomycin for MRSA enterocolitis.
- The patient recovered fully, with successful ostomy reversal and no long-term complications.
- This case highlights a rare presentation of MRSA in a young child.
Implications:
- MRSA enterocolitis should be considered in pediatric cases with persistent diarrhea or high ostomy output, especially when C. difficile and other common causes are excluded.
- Recognizing this rare condition is vital for accurate diagnosis and timely treatment in children.
- This case expands the understanding of MRSA infections in pediatric populations.
