Document Detail

Methicillin-resistant Staphylococcus aureus necrotizing pneumonia arising from an infected episiotomy site.
MedLine Citation:
PMID:  17267886     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We report a case of methicillin-resistant Staphylococcus aureus (MRSA) sepsis and pneumonia in a postpartum patient. CASE: A 21-year-old gravida 1 para 1 presented on postpartum day 9 with persistent elevated fever, dyspnea, cellulitis of the upper extremities, and an infected episiotomy site. Computed tomography of the chest revealed multiple widely distributed nodules and bilateral infiltrates with central cavitations. Sputum, blood, urine, and episiotomy site cultures grew MRSA, subsequently demonstrated by molecular fingerprinting and antibiotic susceptibility to be community acquired. A magnetic resonance imaging of the pelvis demonstrated pelvic thrombophlebitis. CONCLUSION: Community-acquired MRSA is an emerging problem, which may present as skin and soft tissue infections or sepsis. Seeding from an infected episiotomy site seems to be a potential route of systemic infection. The use of empirical treatment with beta-lactam agents may fail. Appropriate cultures should be obtained and if MRSA is diagnosed, vancomycin should be employed.
Michael Rotas; Sandra McCalla; Chunhua Liu; Howard Minkoff
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  109     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-01     Completed Date:  2007-02-20     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  533-6     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York 11219, USA.,
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MeSH Terms
Anti-Bacterial Agents / administration & dosage,  therapeutic use
Diagnosis, Differential
Infusions, Intravenous
Methicillin Resistance*
Pneumonia, Staphylococcal / diagnosis*,  drug therapy,  pathology,  radiography
Puerperal Disorders / diagnosis*,  drug therapy,  pathology
Surgical Wound Infection / diagnosis*,  drug therapy,  pathology
Tomography, X-Ray Computed
Vancomycin / administration & dosage,  therapeutic use
Reg. No./Substance:
0/Anti-Bacterial Agents; 1404-90-6/Vancomycin
Comment In:
Obstet Gynecol. 2007 Jul;110(1):188   [PMID:  17601920 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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