Infective endocarditis caused by community-associated methicillin-resistant Staphylococcus aureus in a previously healthy preschool child
Chun-Yi Lee, Tung-Ming Chang, Chao-Jen Lin, Yhu-Chering Huang*
Received: September 27, 2011 Revised: February 22, 2012 Accepted: February 24, 2012
Corresponding author. Department of Pediatrics, Chang Gung Memorial Hospital, Number 5, Fu-Shin Street, Kweishan, Taoyuan, Taiwan.
Background and purpose:
Community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) has been increasingly reported recently and has become an emerging pathogen of infective endocarditis (IE) in adults, but still rarely reported in children. A previously healthy preschool child without any heart anomaly developed IE and pneumonia with pleural effusion. Blood cultures repeatedly yielded MRSA and did not become negative until 13 days after a teicoplanin-containing regimen was administered. In total, a 4-week intravenous antibiotic therapy and an additional 8-week oral antibiotic therapy were given. The patient recovered uneventfully. All five MRSA blood isolates were molecularly characterized and shared common characteristics, which were consistent with those of the endemic CA-MRSA clone in Taiwan. This case highlights that physicians should be aware of the growing role of CA-MRSA in childhood IE and should meticulously choose an appropriate empiric antibiotic regimen for such a severe disease.
CA-MRSA, Children, Community-associated, Infective endocarditis, Methicillin-resistant Staphylococcus aureus