Ruptured Community-acquired Methicillin-Resistant Staphylococcus aureus (MRSA) Hepatic Abscess in an Immunocompetent...

Methicillin-resistant Staphylococcus aureus (MRSA) is an uncommon etiologic agent of hepatic abscess in children, particularly those without an underlying immunocompromised condition. We describe a rare case of community-acquired MRSA (CA-MRSA) hepatic abscess with rupture into the anterior abdominal wall in an otherwise healthy 3-year-old Filipino male, manifesting as a one-week history of an enlarging epigastric mass accompanied by abdominal pain and fever. He was treated noninvasively with ciprofloxacin (intravenous at 10 mg/kg every 12 hours for 14 days followed by oral at 15 mg/kg every 12 hours for 28 days), and clindamycin (intravenous at 10 mg/kg every 6 hours for 14 days followed by oral at 10 mg/kg every 6 hours for 28 days), resulting in the resolution of the hepatic abscess and its associated symptoms. CA-MRSA hepatic abscess is extremely rare in immuno-competent children, and an appropriate diagnostic approach involving imaging and culture studies is crucial in its diagnosis and management.