Nosocomial methicillin-resistant Staphylococcus aureus endocarditis with splenic abscess in a pregnant woman.
A 36-year-old, 7-week-gravida patient with catheter-related nosocomial infective endocarditis due to methicillin-resistant Staphylococcus aureus (MRSA) is presented in this paper. The patient was admitted to our hospital because of carbon monoxide intoxication. After 14 days, MRSA catheter-related bacteremia developed. The central venous catheter was immediately removed, and teicoplanin therapy was started. Because of persistent fever, leukocytosis, and high C-reactive protein values, endocarditis was suspected. A transesophageal echocardiogram revealed 19-mm vegetation on her mitral valve, confirming the diagnosis of endocarditis. Gentamicin and rifampicin were added to the therapy regimen, and the dose of teicoplanin was increased to 12 mg/kg-day. After 8 days, a splenic abscess was detected by ultrasonography. Vegetation excision, mitral valve replacement by open-heart surgery and splenectomy were performed in the same operation. Antibiotherapy was continued for 6 weeks after surgery, and the patient's condition improved. The development of endocarditis could be prevented by proper clinical practices.
Ozkurt
Zulal
Z
Department of Clinical Bacteriology and Infectious Diseases, Ataturk University School of Medicine, Erzurum, Turkey. zozkurt@atauni.edu.tr
Erkut
Bilgehan
B
Kadanali
Ayten
A
Ates
Azman
A
Yekeler
Ibrahim
I
D000038:Abscess / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D000328:Adult; D016470:Bacteremia / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D002405:Catheterization, Central Venous / Q000009:adverse effects; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology*; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D016106:Methicillin Resistance; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000382:microbiology*; D013158:Splenic Diseases / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology