Open AccessMethicillin-Resistant Staphylococcus aureus-Associated Diarrhea in a Critically Ill Burn Patient
Author(s) -
Aldin Malkoc,
David T. Wong
Publication year - 2021
Publication title -
journal of medical cases
Language(s) - English
Resource type - Journals
eISSN - 1923-4163
pISSN - 1923-4155
DOI - 10.14740/jmc3690
Subject(s) - medicine , diarrhea , staphylococcus aureus , clostridium difficile , enterocolitis , pneumonia , methicillin resistant staphylococcus aureus , bacteremia , vancomycin , antibiotics , respiratory distress , microbiology and biotechnology , surgery , bacteria , genetics , biology
Described in surgical patients after antibiotic use in the 1950s and 1960s, Staphylococcus aureus ( S. aureus ) enterocolitis is a rare form of nosocomial diarrhea. However, S. aureus is not routinely tested like Clostridium difficile ( C. difficile ). We report a case of methicillin-resistant S. aureus (MRSA) enterocolitis found on stool culture in a 22-week pregnant female with a previously negative nasal MRSA culture, and a total burn surface area greater than 60%. She also developed necrotizing MRSA pneumonia and bacteremia. After starting broad-spectrum antibiotic for the necrotizing pneumonia with subsequent acute respiratory distress syndrome, the patient exhibited large voluminous diarrhea that tested positive for MRSA and negative for C. difficile in the stool culture. Similar to other reports of high-volume diarrhea, the diarrhea resolved quickly with enteral vancomycin. S. aureus should be considered along with C. difficile during the workup of nosocomial diarrhea, especially with exposure to broad-spectrum antibiotics in the critically ill patient.