Community Acquired Methicillin-Resistant Staphylococcus Aureus Pneumonia in a Previously Healthy 12-Year-Old Male

ABSTRACT

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) was better recognized to be a nosocomial pathogen found mainly in intensive care units and occurring especially in elderly persons. However, rare but potentially fatal cases of community-acquired MRSA infection have emerged. Risk factors such as infection of the skin or soft tissues, influenza virus infection, history of recent hospital admissions, or immunocompromised status were identified. The prevalence of MRSA in children especially those without risk factors is extremely low. Case This is a case of a previously healthy 12-year-old male who presented with acute onset of high-grade fever and exertional dyspnea. Upon admission, the patient was in respiratory distress and hypotensive. The patient was managed as a case of severe sepsis with the following considerations COVID-19 infection, severe pneumonia, tuberculosis, and malignancy. Although the clinical presentation and imaging findings were suggestive of pulmonary tuberculosis infection, sputum and blood culture were positive for MRSA. The patient required admission to the intensive care unit and underwent close tube thoracotomy insertion and tube pericardiostomy due to the rapid spread of infection. The patient was also treated for pulmonary tuberculosis. Thus, anti-tuberculosis medications were added to Vancomycin, with noted improvement thereafter. Discussion: This case highlights the importance of prompt and accurate diagnosis of MRSA pneumonia leading to optimal patient outcome. With this, the rapid institution of appropriate antibiotics is crucial. However, clinical diagnosis is frequently difficult resulting in to delay of diagnosis.