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Miliary pattern MRSA sepsis following clandestine intravenous infusion

  • Kristan Abernathy
  • Steven Fiester
  • James W. FulcherEmail author
Case Report

Abstract

Intravascular devices aid in drug administration and fluid replacement for hospitalized patients and are thus an integral part of modern medical care; however, poor aseptic technique and improper manipulation of infusion devices increase the risk of infections secondary to catheterization that can progress to sepsis and septic shock. We report the case of a woman who presented with altered mental status after receiving normal saline through an intravenous catheter placed by a medically untrained individual. Less than 24 h following her initial presentation to emergency medical services the patient became unresponsive to multiple vasopressors and broad-spectrum antibiotics and succumbed to septic shock. At autopsy, the decedent had enumerable hemorrhagic lesions consistent with septic emboli, and microscopic examination revealed clusters of coccoid-appearing bacteria. Cultures of the intravenous fluid and IV tubing collected at the decedent’s home grew methicillin-resistant Staphylococcus aureus (MRSA), which was consistent with ante-mortem cultures. This case highlights the rapid clinical deterioration and autopsy presentation of MRSA sepsis due to contamination of the intravenous delivery system.

Keywords

Clandestine IV infusion MRSA sepsis Miliary Contamination 

Notes

Compliance with ethical standards

Conflict of interest

None.

Ethical approval

None required for autopsy case reports in SC.

Informed consent

Not required for autopsy case reports in SC.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Medical StudentUniversity of South Carolina School of Medicine GreenvilleGreenvilleUSA
  2. 2.Department of Biomedical SciencesUniversity of South Carolina School of Medicine GreenvilleGreenvilleUSA
  3. 3.Department of PathologyGreenville Health SystemGreenvilleUSA
  4. 4.Office of the Medical Examiner, Greenville County, South CarolinaPathology Associates of Greenville and the Greenville Health System University Medical CenterGreenvilleUSA

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