A Case Report of Rare and Lethal Methicillin-Resistant Staphylococcus aureus (MRSA) Peritonitis in Infancy

Abstract

Peritoneal inflammation without a discernible intraperitoneal source is referred to as primary peritonitis. Only 2% of pediatric acute abdominal crises are diagnosed preoperatively. Association with other infections is uncommon and is often limited to hepatic and urinary pathogens. Here, we describe a case of primary peritonitis in a one-month-old child who had laparotomy and appendicectomy as per the recommended treatment plan. There were no accompanying hepatic and urinary diseases. In this instance, methicillin-resistant Staphylococcus aureus (MRSA) was the responsible bacteria. The use of linezolid, as per the culture sensitivity report of intraperitoneal pus, ensured a smooth recovery in this case.

Keywords: acute abdominal emergencies; appendicectomy; methicillin resistant staphylococcus aureus (mrsa); perforation peritonitis; primary peritonitis.

Figure 1. X-ray of the abdomen showing a gas shadow reaching the rectum and no pneumoperitoneum.

Figure 2. X-ray of the chest showing bilateral clear lung fields.

Figure 3. Contrast CT of the abdomen showing fluid in the right iliac fossa region (arrow).

CT, computed tomography

Figure 4. Contrast CT of the abdomen showing subtle peritoneal enhancement (arrow).

CT, computed tomography

Figure 5. Normal mucosa with a lymphoid nodule (arrow) in the lamina (HE, 10× magnification).

HE, hematoxylin and eosin

Figure 6. Higher magnification (40×) showing normal appendicular mucosa with cellular infiltration in the subserosa (arrow).