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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
A Case Series Demonstrating the Spectrum of Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA) Disease
Elisée Mbombo1,2, Mubarack Ayamie3, James Makina3
1Pathology Department, Kamuzu University of Health Sciences, Southern Region, Blantyre, Malawi.
Introduction:
Staphylococcus aureus, although a common colonizer of skin and mucous membranes in humans, is associated with severe infections in both healthy and debilitated individuals. The mortality induced by invasive MSSA disease is high, especially in patients diagnosed late. In children, skin and joint manifestations are most common. Septic shock is a major contributing factor to early mortality. To date, reported cases of invasive MSSA disease in children are infrequent, especially in Sub-Saharan Africa.
Case Report:
We present 4 cases of previously healthy children who presented with various clinical manifestations, but skin lesions and fever were common in all of them. They had multisystem involvement and eventually required aggressive multifactorial therapy. Antibiotic treatment was tailored to the results of antimicrobial sensitivity tests following blood culture. Though the hospital stay was quite long, intensive care and appropriate antibiotics contributed to a good prognosis.
Conclusion:
In children with invasive MSSA disease, early diagnosis and prompt management are key factors to improved prognosis. Skin lesions with tender joints in a febrile infant should raise suspicion for a staphylococcal infection. Intensive care and infection source control are the cornerstones of the management.
Insights
Invasive Methicillin-susceptible Staphylococcus aureus (MSSA) infections in children are rare but serious. Early diagnosis and prompt treatment, including intensive care, are crucial for a good prognosis in pediatric MSSA disease.
Area of Science:
- Pediatric Infectious Diseases
- Bacteriology
- Clinical Medicine
Background:
- Staphylococcus aureus is a common human colonizer but causes severe invasive disease.
- Invasive Methicillin-susceptible Staphylococcus aureus (MSSA) disease in children is infrequent, particularly in Sub-Saharan Africa.
- Early diagnosis of invasive MSSA disease is critical due to high mortality, especially from septic shock.
Purpose of the Study:
- To report on cases of invasive MSSA disease in previously healthy children.
- To highlight common clinical manifestations and management strategies.
- To emphasize the importance of early diagnosis and intervention.
Main Methods:
- Case series reporting on four previously healthy children with invasive MSSA disease.
- Clinical manifestations, diagnostic methods (blood culture, antimicrobial sensitivity testing), and therapeutic interventions were reviewed.
- Treatment was tailored based on antimicrobial sensitivity results.
Main Results:
- All four children presented with fever and skin lesions, indicative of multisystem involvement.
- Aggressive multifactorial therapy, including tailored antibiotics and intensive care, was required.
- Despite prolonged hospital stays, appropriate management led to a favorable prognosis.
Conclusions:
- Early recognition of invasive MSSA disease in children, especially with skin lesions and fever, is vital.
- Prompt management, including intensive care and source control, significantly improves outcomes.
- Suspicion for staphylococcal infection should be raised in febrile infants with skin lesions and tender joints.
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