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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

Authors

  • 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

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 (online)

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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.

Keywords

methicillin-resistant Staphylococcus aureus - CA-MRSA - daptomycin - pericarditis - mediastinitis - children