Signs of Methicillin resistant Staphylococcus aureus (MRSA)

Description

A bacterial infection caused by a particular type of Stahylococcus aureus bacteria. The bacteria is resistant to the usual antibiotics and requires treatment with special drugs not ordinarily used. The bacteria can be found on the skin and in the nose but does not always cause an infection. These people are colonized, but do not actually become ill. The infection can involve any part of the body but most commonly affects the skin and soft tissue (cellulitis) or causes a collection of pus (abscess). In the past MRSA was almost exclusively seen in hospitalized patients (hospital acquired MRSA) but now is more commonly seen in otherwise healthy individuals unrelated to a hospital or nursing home visit (community acquired MRSA). Certain people are at increased risk for developing MRSA including: those playing contact sports, people living in crowded conditions (dorms etc.), those sharing towels and sports equipment, patients with weakened immune systems, and people associated with healthcare workers. The infections can be localized to the skin or become widespread and fatal. Young children are especially susceptible to the more serious form.

Symptoms

Red, swollen, and painful patches of skin. Pustular drainage (yellow foul smelling fluid), fever, skin abscess , warmth around the infected area, red streaks traveling up the arm or leg (lymphangitis). More serious infections cause chest pain, chills, fatigue, fever, general ill feeling (malaise), headache, muscle aches, red skin rash, breathing problems, fainting, low blood pressure, and death.

Tests

A history and physical exam will be performed. Additional testing will depend on the clinical situation. Identification of MRSA is typically done by culturing the wound, blood or urine. An imaging study may be done to determine the presence of an collection of pus (abscess) or the extent of the disease. Other tests may be performed to determine damage to other organs.

Standard Workup

CBC
Chem 12
X-Ray
Urine Culture
Ultrasound
MRI
CT Scan
Blood culture
wound culture

Treatment

Treatment depends on the extent of the infection. A simple collection of pus often only requires incision and drainage of the pus. More serious MRSA infections require antibiotics. The decision to use oral or intravenous medications depends on how serious the infection is and the health state of the patient. Resistance to antibiotics is becoming an increasing problem. The medications currently used include: trimethoprim-sulfamethoxazole (Bactrim, Bactrim DS, Septra, Septra DS), linezolid (Zyvox), daptomycin (Cubicin), and vancomycin (Vancocin, Vancoled). Those with very serious infections may require blood pressure and respiratory support as well as treatment for end organ damage such as renal failure.