Septic Pulmonary Emboli following MRSA- Staphylococcus abscess in a Healthy Young Female

Saima Nasreen

Keywords: abscess, blood culture, granulomatous disease, MRSA- Staphylococcus Aureus, septic pulmonary embolus

INTRODUCTION

It is very hard to differentially differentiate such cases and to reach the final diagnosis. It is necessary to find out the site/source from where the bacteria spread in blood. A 30-year-old female was admitted in medical was with a high-grade fever, cough and dyspnea. On clinical examination she was a thin lady with respiratory rate of 28/min, fully conscious, well oriented in time and space. Auscultation of chest revealed crepitations bilaterally in the middle and lower zone. JVP was not raised. Rest of systemic examination was unremarkable except a huge abscess on left thigh with discharging sinuses. The blood culture report isolated MRSA-positive Staphylococcus Aureus. The patient was switched to sensitive antimicrobial agents which were given intra venously for six weeks. Oxygen therapy was maintained for 2 weeks. The patient started improving clinically after 7 days of the treatment and continued improvement until fully recovered. In septicemia and septic emboli, prompt diagnosis can play a crucial role in the survival of the patient.

DISCUSSION

The most serious complication of MRSA- Staphylococcus Aureus is its hematogenous spread to the lungs via emboli dislodged from infective thrombi in various parts of the body. Our patient was young and healthy without any comorbidities, as diabetes mellitus, AIDS etc. This proves that septic emboli in lungs can also occur in healthy individuals. Positive blood culture proved the presence of MRSA- Staphylococcus Aureus infection. A similar case was seen in another setting. And the treatment was same too.³ On the other hand, the microscopic picture of the biopsy of skin tissue from thigh by the histopathologist ruled out the presence of any granulomatous disease or metastasis.

Keywords: abscess, blood culture, granulomatous disease, MRSA- Staphylococcus Aureus, septic pulmonary embolus