Related Experiment Video
Updated: Jul 6, 2025
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Infantile orbital abscess caused by methicillin-resistant Staphylococcus aureus: a case report and literature review
Yanran Qin1, Junming Huo1, Chengjun Liu1
1Department of Intensive Care Unit, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
Objective:
To report and review infantile orbital abscess caused by methicillin-resistant Staphylococcus aureus (MRSA).
Methods:
We report a case of MRSA-induced infantile orbital abscess accompanied by sepsis, pneumonia, and purulent meningitis. We systematically review cases of MRSA-induced infantile orbital abscess published in PubMed, Web of Science and ScienceDirect until April 2023.
Results:
We reviewed 14 patients [our patient + 13 patients (10 papers) identified via literature searches]. There were nine boys and five girls; nine neonates and five older infants; and 8 full-term births and 1 preterm birth. The gestational age at birth was unknown for five infants. The right and left orbits were affected in 10 and 4 patients, respectively. The clinical presentation included periorbital soft-tissue edema or redness (11 patients), fever (7 patients), exophthalmos (10 patients), limited eye movement (4 patients), purulent eye secretions (2 patients), and skin abscess and convulsion (1 patient each). The source of infection was sinusitis (8 patients), vertical transmission, gingivitis, dacryocystitis, upper respiratory tract infection (1 patient each), and unknown (2 patients). MRSA was detected in blood (6 patients) or pus culture (8 patients). Vancomycin or linezolid were used for 11 patients; corticosteroids were administered to only 1 patient. Surgical drainage was performed for 13 infants (external drainage, 11 patients; endoscopic drainage, 2 patients). Two patients initially had pulmonary and intracranial infections. Except for one patient with neurological dysfunction at discharge, all other infants had no sequelae or complications.
Conclusion:
Early aggressive anti-infective treatment and timely drainage are essential for managing MRSA-induced infantile orbital abscess.
Insights
Early aggressive treatment and prompt surgical drainage are crucial for managing infantile orbital abscess caused by methicillin-resistant Staphylococcus aureus (MRSA). This approach minimizes complications and ensures favorable outcomes for affected infants.
Area of Science:
- Ophthalmology
- Pediatrics
- Infectious Diseases
Background:
- Infantile orbital abscess is a rare but serious condition.
- Methicillin-resistant Staphylococcus aureus (MRSA) is an increasingly significant pathogen in pediatric infections.
Observation:
- A case of MRSA-induced infantile orbital abscess with sepsis, pneumonia, and meningitis is presented.
- A systematic review identified 14 cases (including the presented case) of MRSA-induced infantile orbital abscess.
- Common clinical presentations included periorbital edema, fever, and exophthalmos. Sinusitis was the most frequent source of infection.
Findings:
- MRSA was confirmed in blood or pus cultures in all reviewed cases.
- Treatment involved antibiotics (vancomycin or linezolid) and surgical drainage in most patients.
- The majority of infants recovered without sequelae, with one case of neurological dysfunction.
Implications:
- Prompt diagnosis and aggressive management are vital for successful outcomes.
- Early surgical intervention alongside appropriate antibiotic therapy is key.
- This highlights the importance of considering MRSA in the differential diagnosis of infantile orbital infections.
