Multidisciplinary treatment for infective endocarditis complicated with systemic multiple abscess due to Panton-Valentine leukocidin producing community-acquired methicillin-resistant Staphylococcus aureus and Candida albicans: a case report.

BACKGROUND

Infective endocarditis resulting from community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is a rare, but often fatal heart disorder. Here, we report a case of multidisciplinary treatment for infective endocarditis with systemic multiple abscesses due to Panton-Valentine leukocidin (PVL) producing CA-MRSA and Candida albicans .

CASE PRESENTATION

The patient suffered from infective endocarditis, destructive thyroiditis, hemorrhagic cerebral infarction due to mycotic embolism, lung abscess, multiple skeletal muscle abscess, and disseminate intravascular coagulopathy. Aggressive medical treatment as well as mechanical circulatory support was required before the curative surgical treatment. Blood cultures were positive for MRSA and Candida albicans. Genomic analysis of MRSA revealed Staphylococcal Cassette Chromosome mec IVc and also the virulence gene encoding PVL.

CONCLUSIONS

CA-MRSA strains have higher pathogenicity and are more destructive to tissue than healthcare-associated MRSA strains because of the toxins they produce, including PVL. Multidisciplinary treatment including aggressive surgery was required to rescue the patient.