Cavitary pneumonia due to methicillin-resistant staphylococcus aureus in a non-immunocompromised patient after an endoscopy: A case report

Abstract

Objective: Background: Case Report: Conclusions: Rare co-existance of disease or pathology Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia has well-defined characteristics. We present a case of cavitary pneumonia due to MRSA in a patient who had undergone a recent outpatient gastroscopic procedure. A 32-year-old man presented at the Emergency Department with tonic-clonic seizures of 2 min durations. He had a history of seizures without current treatment or use of psychostimulant drugs. His personal history re-ferred to hypothyroidism treated with levothyroxine, morbid type 3 obesity, gastritis with a gastric ulcer, peni-cillin allergies, and an ambulatory endoscopy with a biopsy (7 days ago) for erosive gastropathy. On the 3rd day of admission to the Intensive Care Unit (ICU), a bronchoscopy was performed, which showed a reddened mu-cosa with hemorrhagic points and a cavitary area in the right main bronchus. Multiple polymerase chain reac-tion and mass spectrometry analyses of samples of bronchioalveolar lavage from the bronchus revealed MRSA with a mechanism of resistance to the mecA gene (1×105 colony-forming unit/mL). The laboratory results for the cerebrospinal fluid were negative for bacterial growth. After 6 days, he was discharged from the ICU, although he remained hospitalized for another 4 days. He was followed up through the Outpatient Department and 6 months later he remains in general good health. This is a rare case of cavitary pneumonia due to MRSA of clinical and epidemiological characteristics, which is unusual after an outpatient endoscopic procedure.