Fulminant Methicillin-Sensitive Staphylococcus Aureus Infection: From Pinprick to Multi-organ Failure

Division

East Florida

Hospital

Aventura Hospital and Medical Center

Document Type

Case Report

Publication Date

5-11-2021

Keywords

Staphylococcus aureus, shock, septic shock, pericardiocentesis, death

Disciplines

Bacterial Infections and Mycoses | Cardiology | Critical Care | Internal Medicine

Abstract

A woman in her 60s with diabetes presented to our institution with altered mental status. Preceding symptoms included headaches, nausea and vomiting. One month prior to presentation, she cut her left thumb and developed a pustule, which she occasionally manipulated with a non-sterile needle. On arrival, the patient was in shock, with a Glasgow Coma Scale of 3, requiring emergent intubation and intensive care unit admission. Her initial imaging studies revealed a large pericardial effusion and cerebral subcortical hypodensities. She suffered from a cardiopulmonary arrest with return of spontaneous circulation, with bedside echocardiogram revealing cardiac tamponade. She underwent emergent pericardiocentesis which revealed purulent drainage. Blood, pericardial fluid, cerebrospinal fluid, sputum and urine cultures returned positive for methicillin-sensitive Staphylococcus aureus. The hospital course was further complicated by refractory septic shock and fulminant multiorgan failure, ultimately leading to her demise.

Publisher or Conference

BMJ Case Reports

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