One bacteria, multiple foci

Abstract

A previously healthy 16-year-old male with a ten-day history of proptosis and pain in the left upper eyelid and inflammatory signs of the left lower limb, without fever, was admitted to the Emergency Department. Computed tomography (CT) scan revealed an extensive intraorbital lesion and a multiloculated collection in the muscle planes of the thigh. The boy underwent surgical drainage and was started on empiric antibiotics. Methicillin-susceptible Staphylococcus aureus was isolated from blood and exudate cultures. Because the boy remained febrile, a chest CT scan was performed, which revealed bilateral cavitary lung lesions. He completed a long course of antibiotherapy. The study for potential immunodeficiency disorders was unremarkable.
Most pediatric cases of community-associated Staphylococcus aureus bacteremia are associated with a localized source of infection. Diagnosis depends on isolation from blood and fluid aspirates. Treatment usually requires surgical drainage and intravenous antibiotherapy. Staphylococcus aureus bacteremia may be associated with multiple foci of infection, which should be recognized promptly.