An Interesting Case of Suppurative Thrombophlebitis and Perivascular Abscesses as a Cause of Complicated MRSA Bacteremia

Authors

Ramya Ramachandran, HCA HealthcareFollow
Punjan Patel, HCA HealthcareFollow
Nasima MehrabanFollow
Win Leth Shwe Yee, HCA HealthcareFollow

Files

Division

North Texas

Hospital

Medical City Arlington

Specialty

Internal Medicine

Document Type

Poster

Publication Date

4-28-2023

Keywords

Methicillin Resistant Staphylococcus Aureus, MRSA, bacteremia

Disciplines

Bacterial Infections and Mycoses | Internal Medicine | Pathological Conditions, Signs and Symptoms

Abstract

Methicillin resistant staph aureus (MRSA) Bacteremia has become a serious re-emerging infection. As per the Centers of Disease Control (CDC), the worsening opioid epidemic has created a snowballing effect, in that there is not only an increase in invasive MRSA infections but also in complications from MRSA. Early source control through the form of early foci identification, obtaining serial blood cultures, decolonization and hygiene measures, appropriate antibiotic stewardship are used to eradicate this bacteria and prevent its spread. There are multiple challenges in treating injection drug users with MRSA bacteremia is not only in medical management but also in trying to help them overcome their intravenous (IV) drug abuse and reduce the risk of subsequent infection. This is a unique case report of a 30-year-old female with a past medical history of polysubstance and intravenous heroin use who presented with a painful swelling and blister around the left ankle for the past two weeks. She was found to have MRSA bacteremia with septic pulmonary emboli and suppurative thrombophlebitis of the left lower extremity veins. She had extensive work up to look for the source of infection and her septic embolism. Ultimately, patient centered approach had to be followed given her clinical history and persistent MRSA bacteremia. She was found to have septic thrombophlebitis with multiple abscesses along the left great saphenous vein( GSV). Ultimately, she underwent incision and drainage of her surface abscesses, but the GSV had to be excised as well. Her story highlights the importance of MRSA management from medical and patient standpoint, early source control from endovascular complications and the essential role addiction medicine plays into caring for IV Drug Users.

Original Publisher

HCA Healthcare Graduate Medical Education

Recommended Citation

Ramachandran, Ramya; Patel, Punjan; Mehraban, Nasima; and Yee, Win Leth Shwe, "An Interesting Case of Suppurative Thrombophlebitis and Perivascular Abscesses as a Cause of Complicated MRSA Bacteremia" (2023). North Texas GME Research Forum 2023. 19.
https://scholarlycommons.hcahealthcare.com/northtexas2023/19