title: [Devastating community-acquired Staphylococcus aureus bacteremia].
abstract: Three patients, two men aged 52 and 62 years and a woman aged 83 years, experienced non-specific flu-like symptoms for a few days but subsequently developed a complicated disease with multiple metastatic infections and endocarditis due to bacteraemia. Only the man aged 62 years had a port of entry, a finger wound. Two patients died. Community-acquired S. aureus bacteraemia is a much more serious disease than nosocomial bacteraemia. The community-acquired bacteraemia is characterised by the absence of a primary focus and non-specific flu-like symptoms in the beginning. This results in a long-duration bacteraemia with a high incidence of metastatic infections, endocarditis and a high mortality rate. A multidisciplinary treatment approach with a careful search for and treatment of endocarditic and metastatic infections in combination with long-duration, high-dose antibiotics is warranted.
authors.affiliation: Isala Klinieken, locatie Sophia, afd. Interne Geneeskunde, Postbus 10.400, 8000 GK Zwolle. ejvanderwouden@hetnet.nl
authors.forename: E J
authors.initials: EJ
authors.lastname: van der Wouden
authors.forename: P H P
authors.initials: PH
authors.lastname: Groeneveld
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D016470:Bacteremia / Q000382:microbiology*; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004697:Endocarditis, Bacterial / Q000382:microbiology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000382:microbiology; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality; D013207:Staphylococcal Skin Infections / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents