Ansari Fawwad A, Walls Sheri P, Hewlett Dylan, Biney Priscilla E
Internal Medicine, Piedmont Athens Regional Medical Center, Athens, USA.
Cureus. 2024 Aug 14;16(8):e66889. doi: 10.7759/cureus.66889. eCollection 2024 Aug.
Methicillin-resistant (MRSA) is a prevalent nosocomial pathogen known for causing severe disseminated infections. Recently, there has been an increase in community-acquired MRSA infections. We present a case of MRSA bacteremia complicated by a cervical epidural abscess. A 63-year-old female with no significant past medical history presented with altered mental status lasting two days. She had recently experienced neck stiffness after lifting a heavy object, initially diagnosed as torticollis, at an outside facility. On examination, she appeared ill and met the criteria for sepsis. Blood cultures confirmed MRSA. She developed hypotension, and an MRI of the brain and cervical spine revealed leptomeningeal enhancement and an epidural abscess. MRSA bacteremia, although common, can manifest in various forms. While it typically occurs in patients with identifiable risk factors, our patient had none. Identifying the source of bacteremia is crucial, as effective treatment requires both source control and antibiotic therapy. Given MRSA's high morbidity and mortality, a thorough and rigorous approach to assessment and management is essential.
耐甲氧西林金黄色葡萄球菌（MRSA）是一种常见的医院病原体，以引起严重的播散性感染而闻名。最近，社区获得性MRSA感染有所增加。我们报告一例并发颈椎硬膜外脓肿的MRSA菌血症病例。一名63岁女性，既往无重大病史，出现精神状态改变持续两天。她最近在搬重物后出现颈部僵硬，最初在外院被诊断为斜颈。检查时，她看起来病情严重，符合脓毒症标准。血培养确诊为MRSA。她出现低血压，脑部和颈椎的MRI显示软脑膜强化和硬膜外脓肿。MRSA菌血症虽然常见，但可表现为多种形式。虽然它通常发生在有明确危险因素的患者中，但我们的患者没有这些危险因素。确定菌血症的来源至关重要，因为有效的治疗需要源头控制和抗生素治疗。鉴于MRSA的高发病率和死亡率，采用全面而严谨的评估和管理方法至关重要。
