MRSA Septicemia With Septic Arthritis and Prostatic, Intraretinal, Periapical, and Lung Abscesses.

INTRODUCTION: Methicillin-resistant staphylococcus aureus (MRSA) bacteremia is a life-threatening illness and a major global health care problem. It can cause metastatic and complicated infections. CASE PRESENTATION: A 58-year-old man with uncontrolled type 2 diabetes mellitus presented with altered mental status after a fall. He was found to have a hip fracture, diabetic ketoacidosis, and MRSA bacteremia. This was complicated by septic knee arthritis, prostatic abscess, intraretinal abscess, periapical abscesses, and pulmonary abscesses. He was treated with intravenous vancomycin and oral linezolid and eventually recovered. DISCUSSION: Severe metastatic MRSA infection was likely due, in part, to the patient's uncontrolled diabetes, as he has no underlying immunodeficiency and was HIV negative. Prostatic abscesses are a relatively rare occurrence that typically develop in immunocompromised patients. CONCLUSION: This case is an interesting confluence of sequelae of MRSA bacteremia and reinforces the necessity for clinicians to be diligent when evaluating a patient with a suspected prostatic abscess.

The burden of suicide and homicide of Wisconsin's children and youth.

OBJECTIVE: To describe the epidemiology of violent deaths (suicides and homicides) of children and youth in Wisconsin. METHODS: Linked data from death certificates, coroners or medical examiners, Uniform Crime Reports, police case reports and crime laboratories were analyzed using SPSS 11.5. Analyses from 2000 to 2002 describe suicides and homicides of children and youth under age 25. Rates are per 100,000 population per year. RESULTS: A total of 585 persons under age 25 in Wisconsin died from suicide or homicide during 2000--2002. Suicides outnumbered homicides 323 (55%) to 262 (45%). Firearms were involved in 59% (n=344) of cases. Fatality rates increased with advancing age, ranging from 2.0 in 0-13 year olds to 26.9 in youth age 21-24. There were over twice as many violent deaths compared to cancer and infectious disease deaths combined (n=253). CONCLUSION: Suicides and homicides are a significant burden on the children and youth of Wisconsin. An investment in reducing this burden requires comprehensive data and informed programs and policies. We recommend that physicians and public health community leaders collaborate with the criminal justice community and policy makers to develop, implement, and evaluate prevention programs and policies.