Methicillin-resistant Staphylococcus aureus enterocolitis sequentially complicated with septic arthritis: a case report and review of the literature
- PMID: 24405901
- PMCID: PMC3892063
- DOI: 10.1186/1756-0500-7-21
Methicillin-resistant Staphylococcus aureus enterocolitis sequentially complicated with septic arthritis: a case report and review of the literature
Abstract
Background: Although most reports describing patients infected with methicillin-resistant Staphylococcus aureus enterocolitis have been published in Japan, this concept remains a matter of debate and diagnostic criteria have not yet been defined.
Case presentation: The general status of a 74-year-old Japanese man referred to our hospital (day 1) with severe community-acquired pneumococcal pneumonia gradually improved with antibiotic therapy. Thereafter, up to 4 L/day of acute watery diarrhea that started on day 19 was refractory to metronidazole but responded immediately to oral vancomycin. Gram staining stool samples was positive for abundant fecal leukocytes from which dominant methicillin-resistant Staphylococcus aureus (10(4) CFU/mL) were isolated, suggesting methicillin-resistant Staphylococcus aureus enterocolitis. High fever with methicillin-resistant Staphylococcus aureus bacteremia was evident at day 30, and suppurative right hip arthritis developed around day 71. All methicillin-resistant Staphylococcus aureus strains isolated from stools, blood and aspirated synovial fluid separated in the same manner on pulsed-field gel electrophoresis, as well as two other strains isolated from sputum, belonged to the same clone as sequence type (ST) 764 (complex clonal 5), and carried SCCmec type II.
Conclusion: The clinical, microbiological and molecular biological findings of this patient indicated methicillin-resistant Staphylococcus aureus enterocolitis that led to septic methicillin-resistant Staphylococcus aureus arthritis.
Figures




Similar articles
-
Methicillin-resistant Staphylococcus aureus enterocolitis in a 16-month-old boy: a case report.J Med Case Rep. 2022 Apr 17;16(1):155. doi: 10.1186/s13256-022-03381-z. J Med Case Rep. 2022. PMID: 35429977 Free PMC article.
-
Methicillin-resistant Staphylococcus aureus carrying SCCmec type II was more frequent than the Brazilian endemic clone as a cause of nosocomial bacteremia.Diagn Microbiol Infect Dis. 2013 Aug;76(4):518-20. doi: 10.1016/j.diagmicrobio.2013.04.024. Epub 2013 May 27. Diagn Microbiol Infect Dis. 2013. PMID: 23719088
-
Molecular and phenotypic characteristics of methicillin-resistant and vancomycin-intermediate staphylococcus aureus isolates from patients with septic arthritis.J Clin Microbiol. 2009 Nov;47(11):3617-23. doi: 10.1128/JCM.00539-09. Epub 2009 Sep 16. J Clin Microbiol. 2009. PMID: 19759226 Free PMC article.
-
Acute haematogenous community-acquired methicillin-resistant Staphylococcus aureus osteomyelitis in an adult: case report and review of literature.BMC Infect Dis. 2012 Oct 25;12:270. doi: 10.1186/1471-2334-12-270. BMC Infect Dis. 2012. PMID: 23098162 Free PMC article. Review.
-
Staphylococcus aureus bacteremia, risk factors, complications, and management.Crit Care Clin. 2013 Jul;29(3):547-62. doi: 10.1016/j.ccc.2013.03.008. Crit Care Clin. 2013. PMID: 23830653 Review.
Cited by
-
A Case of Postoperative Methicillin-Resistant Staphylococcus aureus Enterocolitis in an 81-Year-Old Man and Review of the Literature.Am J Case Rep. 2020 Sep 29;21:e922521. doi: 10.12659/AJCR.922521. Am J Case Rep. 2020. PMID: 32989210 Free PMC article. Review.
-
Targeting staphylococcal enterotoxin B binding to CD28 as a new strategy for dampening superantigen-mediated intestinal epithelial barrier dysfunctions.Front Immunol. 2024 Mar 6;15:1365074. doi: 10.3389/fimmu.2024.1365074. eCollection 2024. Front Immunol. 2024. PMID: 38510259 Free PMC article.
-
Methicillin-Resistant Staphylococcus aureus as a Probable Cause of Antibiotic-Associated Enterocolitis.Case Rep Infect Dis. 2018 Aug 5;2018:3106305. doi: 10.1155/2018/3106305. eCollection 2018. Case Rep Infect Dis. 2018. PMID: 30174968 Free PMC article.
-
Pseudomembranous colitis secondary to methicillin-resistant Staphylococcus aureus (MRSA).BMJ Case Rep. 2016 May 10;2016:bcr2016215225. doi: 10.1136/bcr-2016-215225. BMJ Case Rep. 2016. PMID: 27165998 Free PMC article.
-
Fatal infection with enterocolitis from methicillin-resistant Staphylococcus aureus and the continued value of culture in the era of molecular diagnostics.Leuk Res Rep. 2021 May 24;15:100254. doi: 10.1016/j.lrr.2021.100254. eCollection 2021. Leuk Res Rep. 2021. PMID: 34136343 Free PMC article.
References
-
- Case definitions for infectious conditions under public health surveillance. Centers for disease control and prevention. MMWR Recomm Rep. 1997;46(RR-10):1–55. http://www.ncbi.nlm.nih.gov/pubmed/9148133. - PubMed
-
- Multi Locus Sequence Typing home page. http://www.mlst.net/
-
- Morita H, Tani M, Adachi H, Kawai S. Methicillin-resistant Staphylococcus aureus (MRSA) enteritis associated with prophylactic cephalosporin administration and hypochlorhydria, after subtotal gastrectomy. Am J Gastroenterol. 1991;86(6):791–792. - PubMed
-
- Hori K, Yura J, Shinagawa N, Sakurai S, Mashita K, Mizuno A. Postoperative enterocolitis and current status of MRSA enterocolitis–the result of a questionnaire survey in Japan. Kansenshogaku Zasshi. 1989;63(7):701–707. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Molecular Biology Databases