Methicillin-resistant Staphylococcus aureus bacteremia and chorioamnionitis after recurrent marsupialization of a bartholin abscess.
BACKGROUND
Methicillin-resistant Staphylococcus aureus (MRSA) is an extremely rare etiology of chorioamnionitis.


METHODS
A young primigravida, with sickle cell (Hb SS) disease and beta thalassemia presented at 37 weeks of gestation with fever, chills, and lower abdominal pain in the presence of intact fetal membranes, 10 days after recurrent marsupialization of a Bartholin abscess. Overt clinical chorioamnionitis was diagnosed. The patient received intravenous triple antibiotics and delivered by immediate cesarean. Maternal blood, uterine, placental and neonatal nares, external auditory canal, and umbilical cord stump cultures all yielded MRSA. Both the mother and infant received intravenous vancomycin and did well.


CONCLUSIONS
Our case and the literature suggest that it may be prudent to consider MRSA when contemplating the possibility of chorioamnionitis in the presence of intact fetal membranes, especially in gravidas with recurrent admissions or minor surgical procedures or who are hospital staff.
Sherer
David M
DM
From the Department of Obstetrics and Gynecology, the Divisions of Maternal Fetal Medicine, and Gynecologic Oncology, State University of New York, Downstate Medical Center, Brooklyn, New York.
Dalloul
Mudar
M
Salameh
Ghadir
G
Abulafia
Ovadia
O
D000038:Abscess / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D016470:Bacteremia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D001472:Bartholin's Glands / Q000601:surgery*; D002821:Chorioamnionitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus; D011183:Postoperative Complications; D011247:Pregnancy; D012008:Recurrence; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D055815:Young Adult