Disseminated community-acquired USA300 methicillin-resistant Staphylococcus aureus pyomyositis and septic pulmonary emboli in an immunocompetent adult.
BACKGROUND
Recent reports have increasingly recognized methicillin-resistant Staphylococcus aureus (MRSA) as an important etiology of pyomyositis, an uncommon disease entity. Specific virulence factors such as the Panton-Valentine leukocidin protein have been identified that may play a role in the pathophysiology of pyomyositis, especially when community-acquired MRSA is implicated.


METHODS
We review a case of disseminated pyomyositis and septic pulmonary emboli in an immunocompetent adult in whom a pvl+ USA300 clone was isolated.


RESULTS
The degree of dissemination in this patient suggests an emerging level of virulence for community-acquired MRSA that has not been reported previously.


CONCLUSIONS
The clinical history and management of severe disseminated pyomyositis, including diagnostic modalities, antimicrobial therapy, and surgical drainage, require an aggressive approach.
Woodward
Joseph F
JF
Department of Surgery, University of Washington, Seattle, WA, USA. Joseph.Woodward@ucsfmedctr.org
Sengupta
Dhruba J
DJ
Cookson
Brad T
BT
Park
James O
JO
Dellinger
E Patchen
EP
D015373:Bacterial Typing Techniques; D017714:Community-Acquired Infections / Q000382:microbiology; D016172:DNA Fingerprinting; D005838:Genotype; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D009132:Muscles / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000382:microbiology*; D052880:Pyomyositis / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology; D011859:Radiography; D013203:Staphylococcal Infections / Q000382:microbiology*; D055815:Young Adult