TY - JOUR
T1 - A Fatal Case of Disseminated Infection Caused by Community-Associated Methicillin-Resistant Staphylococcus aureus USA300 Clone
AU - Ote, Hiroyuki
AU - Ito, Hideyuki
AU - Akira, Taroh
AU - Sugai, Motoyuki
AU - Hisatsune, Junzo
AU - Uehara, Yuki
AU - Oba, Yuichiro
N1 - Publisher Copyright:
© 2023, National Institute of Health. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Methicillin-resistant Staphylococcus aureus (MRSA) USA300 is a representative community-associated MRSA (CA-MRSA) clone worldwide. Herein, we report the case of a patient with USA300 clone infection who could not be salvaged. A 25-year-old man who had sex with men presented with symptoms including fever persisting for one week and skin lesions located on the buttocks. Computed tomography imaging showed multiple nodules and consolidations, especially in the peripheral lung fields, right iliac vein thrombosis, and pyogenic myositis of medial thighs bilaterally. Blood cultures revealed MRSA bacteremia. The patient’s condition deteriorated rapidly, complicated by acute respiratory distress syndrome and infective endocarditis. Despite the intubation on the 6th hospital day, he died on the 9th day. Multilocus sequence typing of this patient’s MRSA strain revealed sequence type 8 with a staphylococcal cassette chromosome of mec type IVa, Panton-Valentine leukocidin gene, and the arginine catabolic mobile element, indicating presence of the USA300 clone. Patients with CA-MRSA skin lesions presenting with furuncles or carbuncles on the lower body are at a higher risk of severe disease. The patient’s background, appearance, and location of skin lesions are critical for the early diagnosis of severe CA-MRSA infection.
AB - Methicillin-resistant Staphylococcus aureus (MRSA) USA300 is a representative community-associated MRSA (CA-MRSA) clone worldwide. Herein, we report the case of a patient with USA300 clone infection who could not be salvaged. A 25-year-old man who had sex with men presented with symptoms including fever persisting for one week and skin lesions located on the buttocks. Computed tomography imaging showed multiple nodules and consolidations, especially in the peripheral lung fields, right iliac vein thrombosis, and pyogenic myositis of medial thighs bilaterally. Blood cultures revealed MRSA bacteremia. The patient’s condition deteriorated rapidly, complicated by acute respiratory distress syndrome and infective endocarditis. Despite the intubation on the 6th hospital day, he died on the 9th day. Multilocus sequence typing of this patient’s MRSA strain revealed sequence type 8 with a staphylococcal cassette chromosome of mec type IVa, Panton-Valentine leukocidin gene, and the arginine catabolic mobile element, indicating presence of the USA300 clone. Patients with CA-MRSA skin lesions presenting with furuncles or carbuncles on the lower body are at a higher risk of severe disease. The patient’s background, appearance, and location of skin lesions are critical for the early diagnosis of severe CA-MRSA infection.
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U2 - 10.7883/yoken.JJID.2022.578
DO - 10.7883/yoken.JJID.2022.578
M3 - Article
C2 - 37005273
AN - SCOPUS:85165546507
SN - 1344-6304
VL - 76
SP - 251
EP - 254
JO - Japanese journal of infectious diseases
JF - Japanese journal of infectious diseases
IS - 4
ER -