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“A Fatal Case of Community Acquired Methicillin Staphylcoccus aureus (CA-MRSA)”

“A Fatal Case of Community Acquired Methicillin Staphylcoccus aureus (CA-MRSA)”. CASE REPORT Samya V. Cruz LT MC USN. INTRODUCTION. Common cause of tissue infections Emergence of community-acquired MRSA (CA-MRSA) Traditional versus non-traditional risk factors

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“A Fatal Case of Community Acquired Methicillin Staphylcoccus aureus (CA-MRSA)”

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  1. “A Fatal Case of Community Acquired Methicillin Staphylcoccus aureus (CA-MRSA)” CASE REPORT Samya V. Cruz LT MC USN

  2. INTRODUCTION • Common cause of tissue infections • Emergence of community-acquired MRSA (CA-MRSA) • Traditional versus non-traditional risk factors • Military members especially susceptible • CASE: 20-year-old active duty member

  3. CASE PRESENTATION • Chief Complaint: “Painful spider bite” • Small erythematous papule with necrotic center • Incised the abscess then discharged • Given analgesic, antibiotic, follow-up instructions, placed on sick-in-quarters • At 36 hours, patient failed to follow-up

  4. CASE PRESENTATION • Discovered in the barracks in respiratory distress • Initial oxygen saturation 78% with 5L nasal cannula • Elevated white count with a left shift • Chest xray: diffuse, bilateral patchy infiltrates

  5. CASE PRESENTATION • Acute respiratory distress and renal failure • Leukopenic and thrombocytopenic • Transferred to tertiary care center • Patient passed 48 hours later • Blood Cultures positive for CA-MRSA

  6. DISCUSSION • Over half of all staphylococcal isolates caused by CA-MRSA • Outbreaks identified in recruit and school commands • Navy Environmental Health Center guidelines -- August 2006

  7. CURRENT PRACTICE MANAGEMENT • Clinical practice guidelines • Prevention through good hygiene • Early presentation • Medical staff recognition and treatment • Close follow-up through daily reports

  8. CONCLUSION • CA-MRSA: Increasing significance in the military population • Mild infections will respond to early intervention • Aggressive Prevention and Management will protect the health of our personnel

  9. REFERENCES • https://nh-psfl-intra.pcola.med.navy.mil/Clinician Tools/MRSA/MRSA Guideline AUG06.pdf • https://nh-psfl-intra.pcola.med.navy.mil/Clinician Tools/Antibiogram/2005%20 ANTIBIOGRAM PHARMACY.doc • Gorwitz RJ, Jernigan DB, Powers JH, Jernigan JA, and Participants in the CDC-Convened an Experts’ Meeting on Management of MRSA in the Community. Strategies for clinical management of MRSA in the community: Summary of an experts’ meeting convened by the Centers for Disease Control and Prevention. 2006 Available at http://cdc.goc/ncidod/dhqp/ar mrsa ca.html. • Centers for Disease Control and Prevention. Methicilli-resistant Staphylococcus aureus skin and soft tissue infections in a state prison – Mississippi, 2000. MMWR Morbidity Mortality Weekly Report 2001; 50:919-22. • Chambers, H. The changing epidemiology of Staphylococcus aureus? Emergency Infectious Disease 2001; 7:178-82.

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