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Lemierre-like syndrome caused by community-associated methicillin-resistant Staphylococcus aureus complicated by hemorrhagic pericarditis
- Source :
- Pediatric Critical Care Medicine. 11:e32-e35
- Publication Year :
- 2010
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2010.
-
Abstract
- To describe an infant with Lemierre-like syndrome caused by community-associated methicillin-resistant Staphylococcus aureus whose course was complicated by hemorrhagic pericarditis.Case report.A 30-bed, pediatric intensive care unit at a tertiary care children's hospital.A 7-month-old infant presented with fever and torticollis attributable to a retropharyngeal abscess and left internal jugular venous thrombosis. He was treated with antibiotics and anticoagulation, and his course was complicated by hemorrhagic pericarditis and cardiac tamponade.Resuscitation of shock; video-assisted thoracoscopic drainage of bilateral empyema with pleural decortication; vancomycin and clindamycin treatment of methicillin-resistant Staphylococcus aureus; incision and drainage of retropharyngeal abscess; treatment of internal jugular venous thrombus with anticoagulation; and treatment of pericardial tamponade by insertion of pericardial drain.Methicillin-resistant Staphylococcus aureus from blood and pleural fluid peel cultures were multi-locus sequence type 8, Panton-Valentine leukocidin-positive, and contained SCCmec IV, findings consistent with USA300 pulsotype. There was complete recovery from this life-threatening infection.Septic jugular venous thrombophlebitis complicating upper airway infections is a rare but serious acute medical condition. We present an infant with methicillin-resistant Staphylococcus aureus infection and clinical features that overlapped those described by Lemierre, in whom hemorrhagic pericarditis developed while receiving anticoagulation therapy. Anticoagulation, if used, should be closely monitored in this population.
- Subjects :
- Male
Methicillin-Resistant Staphylococcus aureus
medicine.medical_specialty
MEDLINE
Hemorrhagic Disorders
Intensive Care Units, Pediatric
Critical Care and Intensive Care Medicine
medicine.disease_cause
Thrombophlebitis
Pericarditis
Internal medicine
medicine
Humans
Torticollis
Pediatric intensive care unit
business.industry
Infant
Retropharyngeal abscess
Clindamycin
Syndrome
Staphylococcal Infections
Retropharyngeal Abscess
medicine.disease
Methicillin-resistant Staphylococcus aureus
Staphylococcus aureus
Pediatrics, Perinatology and Child Health
Jugular Veins
business
medicine.drug
Subjects
Details
- ISSN :
- 15297535
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Pediatric Critical Care Medicine
- Accession number :
- edsair.doi.dedup.....d8e27a73ca925402149498449a5bb74a