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- W4283169799 abstract "TYPE: Late Breaking Case Report TOPIC: Critical Care INTRODUCTION: Methicillin-resistant staphylococcus aureus (MRSA) purulent pericarditis is a life-threatening infection, characterized by frank pus collection in the pericardium1-4. While incidents of MRSA infection continue to increase, MRSA pericarditis remains extremely rare in the absence of prior surgical intervention1,4. We present a rare case of disseminated MRSA infection with purulent pericarditis. CASE PRESENTATION: This is a 71-year-old male who presented with a 12 days history of cough and shortness of breath. Vital signs were 153/81mmHg, 98.5oF, 76bpm, 18bpm, 85%. He was diagnosed with novel coronavirus-19 (COVID-19), started on remdesivir, corticosteroids, and vitamins. Blood and urine cultures resulted negative. He continued to improve. Three weeks into the hospitalization, he reported chest pain and clinically decompensated with refractory hypotension, tachycardia, and hypoxia, requiring increased supplemental oxygen and vasopressor support. Echocardiogram revealed pericardial effusion with early tamponade physiology. Patient underwent pericardial window with drainage of 600 mL of purulent fluid. Repeat labs revealed white blood cell count of 25.3K/uL, platelets of 69 K/uL, lactic acid of 5.0 mmol/L. MRSA grew from blood, urine, respiratory and pericardial fluid cultures. Patient was started on intravenous vancomycin. DISCUSSION: Purulent pericarditis due to MRSA is typically seen in immunocompromised state or with prior surgical intervention. While the source of pericarditis in our patients remains unclear, we suspect intrathoracic or hematogenous spread, compounded with an immunosuppressive state, attributed to COVID therapy with corticosteroids. CONCLUSIONS: This case not only illustrates a rare case of disseminated MRSA purulent pericarditis, but it also depicts the importance of heightened suspicion, prompt diagnosis, and early initiation of treatment. DISCLOSURE: Nothing to declare. KEYWORD: Disseminated MRSA Infection" @default.
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- W4283169799 date "2022-06-01" @default.
- W4283169799 modified "2023-09-26" @default.
- W4283169799 title "DISSEMINATED MRSA INFECTION WITH PURULENT PERICARDITIS: AN EXTREMELY RARE CASE, LIKELY MORE COMMON THAN REPORTED" @default.
- W4283169799 doi "https://doi.org/10.1016/j.chest.2021.12.242" @default.
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