title: First reported case of infective endocarditis caused by community-acquired methicillin-resistant Staphylococcus aureus not associated with healthcare contact in Brazil.
abstract: We report here the first case of endocarditis due to CA-MRSA not associated with healthcare contact in Brazil in Brazil. A previously healthy patient presented with history of endocarditis following a traumatic wound infection. Patient had multiple positive blood cultures within 72 h of admission and met modified Duke's criterion for infective endocarditis. The isolate was typed as Staphylococcal cassette chromosome (SCC) mec type IV and was positive for presence of Panton-Valentine leukocidin (PVL). Increased incidence of CA-MRSA endocarditis is a challenge for the internist to choose the best empirical therapy. Several authors have suggested an empirical therapy with both a beta-lactam and an anti-MRSA agent for serious S. aureus infections. Our patient was treated with Vancomycin and made complete recovery in 3 months.
authors.affiliation: Clementino Fraga Filho Hospital, Rio de Janeiro, RJ, Brazil. c.fortes@globo.com
authors.forename: Claudio Querido
authors.initials: CQ
authors.lastname: Fortes
authors.forename: Claudia Adelino
authors.initials: CA
authors.lastname: Espanha
authors.forename: Flavio Pedreira
authors.initials: FP
authors.lastname: Bustorff
authors.forename: Bruno Cordeiro
authors.initials: BC
authors.lastname: Zappa
authors.forename: Adriana Lucia Pires
authors.initials: AL
authors.lastname: Ferreira
authors.forename: Regina Barbosa
authors.initials: RB
authors.lastname: Moreira
authors.forename: Nelson Gonçalves
authors.initials: NG
authors.lastname: Pereira
authors.forename: Vance G
authors.initials: VG
authors.lastname: Fowler
authors.forename: Hitesh
authors.initials: H
authors.lastname: Deshmukh
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics* / Q000302:isolation & purification; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*