title: [Community-acquired methicillin-resistant Staphylococcus aureus disseminated disease].
abstract: A 21 year old man, previously healthy, presented with subcutaneous nodes consistent with gummas. Ultrasonography disclosed multiple subcutaneous abscesses and images suitable with piomiositis, pleural and pericardium effusion. A puncture-aspirate with fine-needle was performed and produced purulent material, with isolate of Staphylococcus aureus. Antimicrobial susceptibility testing by disk diffusion showed resistant to cefalotin, erythromycin and clindamycin, and susceptibility to trimethoprim-sulfamethoxazole, ciprofloxacin and rifampicin. Methicilin-resistance was confirmed by Staphyslide agglutination testing (Biomérieux). The patient was treated with ciprofloxacin and rifampicin during four weeks, with a good clinical response. The frequency of CA-MRSA infections is increasing, and these are reported in patients without identified predisposing risks leading to failure on empiric therapy for community infections presumed to be due to staphylococcal agents.
authors.affiliation: Unidad 9, Hospital de Enfermedades Infecciosas Francisco Javier Muñiz, Buenos Aires, Argentina. clarisabrezzo@aol.com
authors.forename: Clarisa
authors.initials: C
authors.lastname: Brezzo
authors.forename: Diego
authors.initials: D
authors.lastname: Cecchini
authors.forename: Fernando
authors.initials: F
authors.lastname: Biscione
authors.forename: Tomás
authors.initials: T
authors.lastname: Orduna
authors.forename: Nora
authors.initials: N
authors.lastname: Costa
authors.forename: Mirta
authors.initials: M
authors.lastname: Quinteros
mesh_terms: D000038:Abscess / Q000382:microbiology; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D008297:Male; D016106:Methicillin Resistance / Q000187:drug effects*; D012293:Rifampin / Q000627:therapeutic use; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology*; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000382:microbiology; D013211:Staphylococcus aureus
chemical_list: D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D012293:Rifampin