J Pediatr Intensive Care 2018; 07(02): 097-101
DOI: 10.1055/s-0037-1607325
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Community-Acquired MRSA Pericarditis and Mediastinitis in a Previously Healthy Infant

Joselito Sanchez
1  Division of Infectious Diseases and Immunology, Department of Pediatrics, New York University School of Medicine, New York, New York
,
Amanda Schneider
2  Department of Pediatrics, New York University School of Medicine, New York, New York
,
Justin T. Tretter
3  Division of Cardiology, Department of Pediatrics, New York University School of Medicine, New York, New York
,
Bo Shopsin
4  Division of Infectious Diseases, Department of Medicine, New York University School of Medicine, New York, New York
,
Yasir Al-Qaqaa
5  Division of Critical Care, Department of Pediatrics, New York University School of Medicine, New York, New York
,
Alka Khaitan
1  Division of Infectious Diseases and Immunology, Department of Pediatrics, New York University School of Medicine, New York, New York
,
Tanya Chadha
6  Division of Critical Care, Department of Pediatrics, University of Florida College of Medicine, Jacksonville, Florida
› Author Affiliations
Funding Genotyping of the MRSA isolates was supported by the National Institutes of Health (R01-AI103268 to Bo Shopsin).
Further Information

Publication History

06 July 2017

16 September 2017

Publication Date:
26 October 2017 (eFirst)

Abstract

Invasive community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections disproportionately affect children, but there are few pediatric reports of pericarditis and mediastinitis caused by CA-MRSA in previously healthy children. Here we report a severe case of CA-MRSA pericarditis with extension to the mediastinum and carotid sheath in a previously healthy 8-month-old infant who was successfully treated with surgical interventions and with a combination of daptomycin and vancomycin. The relatively indolent clinical course in this patient was notable given the significant extent of infection. This case highlights the potential virulence of CA-MRSA in previously healthy children and the importance of early diagnosis, prompt drainage, and appropriate antibiotic coverage.