title: [A case report of urinary tract infection and meningitis caused by methicillin-resistant Staphylococcus aureus (MRSA) after transurethral resection of the prostate].
abstract: We present a case of meningitis that developed following a urinary tract infection caused by methicillin-resistant Staphylococcus aureus (MRSA) after transurethral resection of the prostate. The patient, a 69-year-old man with diabetes mellitis, underwent transurethral resection of the prostate following a diagnosis of benign prostatic hypertrophy. On the 4 th day after surgery, high fever occurred immediately after the removal of the indwelling urethral catheter. Cultures of urine and blood revealed MRSA. On the 6 th day after surgery, severe lumbago was evident and MRSA was isolated from cerebrospinal fluid. Separate administration of arbekacin or vancomycin, to which the isolated MRSA was sensitive, was not effective. Combined therapy with fosfomycin, vancomycin and human immunoglobulin effectively relieved the inflammation. Although it is generally reported that the pathogenicity of MRSA is low in the urinary tract, this case suggests that a urinary tract infection caused by MRSA can advance to sepsis and meningitis.
authors.affiliation: Department of Urology, Yokohama Sakae Kyosai Hospital.
authors.forename: C
authors.initials: C
authors.lastname: Seto
authors.forename: A
authors.initials: A
authors.lastname: Ikeda
authors.forename: M
authors.initials: M
authors.lastname: Ohkawa
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000628:therapy; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D005578:Fosfomycin / Q000008:administration & dosage; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage; D008297:Male; D016920:Meningitis, Bacterial / Q000209:etiology* / Q000628:therapy; D016106:Methicillin Resistance; D011183:Postoperative Complications; D011468:Prostatectomy; D013203:Staphylococcal Infections / Q000209:etiology* / Q000628:therapy; D014552:Urinary Tract Infections / Q000209:etiology* / Q000382:microbiology / Q000628:therapy; D014640:Vancomycin / Q000008:administration & dosage
chemical_list: D007136:Immunoglobulins; D005578:Fosfomycin; D014640:Vancomycin