MRSA

Abstract

The patient, a 16-year-old male, who was a previously healthy high school athlete, was admitted to the intensive care unit via the emergency department (ED) with a four day history of fever, chills, and occasional rigor, myalgia, and productive cough, now with increasing dyspnea and hemoptysis over the past 24 hours. His temperature was 38.1°C, blood pressure was 133/87 mm Hg, pulse 104 beats per minute, and his respiratory rate 16 per minute. He was well developed and well nourished, but in respiratory distress, with tachycardia and coarse rhonchi bilaterally at the bases of both lungs. Six weeks prior to presentation, the patient was hospitalized for knee surgery due to an injury he sustained in a North American basketball tournament. At the time of surgery the patient was screened for methicillin-resistant Staphylococcus aureus (MRSA) with an FDA-approved MRSA polymerase chain reaction (PCR) assay, as part of a hospital-wide active surveillance program, aimed at prevention of hospital transmission of infections. At that time, the surveillance test result was reported as “MRSA Detected.” There was no personal or family history of diabetes mellitus and no immunosuppression. The patient denied HIV risk factors and denied the use of illicit drugs.