We discussed a case of non-specific abdominal pain and the
diagnosis was found to be a staphylococcus aureus epidural abscess!
Just to recap, here are a few key points about
staphylococcus aureus bacteremia:
- Always take a finding of staph aureus in the blood seriously. This infection is associated with high mortality and morbidity. Staph aureus can spread rapidly and lead to abscesses. Remember that staph loves the spine (among other organs) and is a common cause of endocarditis. Treatment consists of antibiotics and source control (just like every infectious disease). Vancomycin a good choice for empiric treatment to cover MRSA until the culture sensitivity can guide further management. If you find out that the organism is MSSA then a 4-6 week course of cloxacillin is generally sufficient. Also – ID consultation has been shown to reduce mortality in staph aureus bacteremia so make sure to involve your ID colleague early!
- Look for a source. Keep in mind that the chances of finding a source are quite good if the patient acquires the bacteremia in hospital; however, we only identify a source in about 50% of patients who present from the community. Make sure to do a detailed history, physical and appropriate investigations to assess for sources like prosthetic material, septic joint, skin and soft tissue infections, endocarditis, endovascular lines and spinal/epidural abscesses. This includes a TTE to rule out endocarditis. However, keep in mind that TTE is not perfect at picking up endocarditis so you need to do a TEE if you are concerned.
- Assess for complications. If and when you find a source of the infection, take some time to assess for complications associated with staph aureus bacteremia. Remember that staph aureus has the ability to metastasize to almost anywhere in the body so once you find a source, look carefully to rule out any other foci of infection. Pay attention to findings like new back pain (even if very mild), joint pain, or even subtle physical findings of endocarditis. Renal and pulmonary sites of spread should also be considered.
- Staph in the urine can be a marker for staph in the blood. Staph aureus in the urine is weird! It is not a typical organism we think about when considering UTI. So, this finding should prompt you to send blood cultures which may reveal staph aureus bacteremia.
- A case from the CMPA to see how the diagnosis can be missed and how catastrophic this can be for a patient: https://www.cmpa-acpm.ca/web/guest/-/spinal-epidural-abscess-a-rare-insidious-and-potentially-catastrophic-infection
- Corey, G. Ralph. "Staphylococcus aureus bloodstream infections: definitions and treatment." Clinical Infectious Diseases 48.Supplement 4 (2009): S254-S259
7 comments :
Massive Gratitude to doctor Razor who got my Genital Herpes cured a month ago. I have been reading so many comments of some people who were cured from various diseases by Doctor Razor, but i never believed them. I was hurt and depressed, I was too curious and wanted to try Doctor Razor, then I contacted him through his email (drrazorherbalhome@gmail.com) when I contacted him, he assured me 100% that he will heal me, I pleaded with him to help me out. I also got His Website : https://drrazorherbalhome.wixsite.com/drrazorherbalhome. My treatment was a great success, he healed me just as he promised. He sent me his medication and asked me to go for check up after 18 days of taking his herbal medicine. I agreed with him and I took his medication and went for check up, to my greatest surprise my result came out negative after the treatment, I'm really delighted that i'm completely cured and healthy again. I waited for a month to be very sure I was completely healed before writing this testimony. I did another blood test one week ago and it was still Herpes negative. so i guess its time i recommend anyone going through Herpes HSV-1 or HSV-2, HIV, HPV, Hepatitis B, Diabetes, Cancer should reach him. EMAIL: drrazorherbalhome@gmail.com. WHATSAPP: +2349065420442 My greatest joy is having back my happiness
Am Laura Mildred by name, i was diagnosed with Herpes 4 years ago i lived in pain with the knowledge that i wasn't going to ever be well again i contacted so many herbal doctors on this issue and wasted a large sum of money but my condition never got better i was determined to get my life back so one day i saw Mr. Morrison Hansen post on how Dr. Emu saved him from Herpes with herbal medicine i contacted Dr. Emu on his Email: Emutemple@gmail.com we spoke on the issue i told him all that i went through and he told me not to worry that everything will be fine again so he prepared the medicine and send it to me and told me how to use it, after 14 days of usage I went to see the doctor for test,then the result was negative, am the happiest woman on earth now thanks to Dr. Emu God bless you. Email him at: Emutemple@gmail.com Whats-app or Call him: +2347012841542
Herpes can be cured because it truly has a complete cure. I’m a living witness of it because I recently got rid of my HSV VIRUS within just two weeks. And as i speak right now! I’m perfectly cured from the herpes disease. There is a cure and it's called herbal medicine. I'm so glad to have come in contact with Herbal doctor Kham who is also known as the two weeks healer of herpes virus. Doctor Kham got me cured completely from my long term genital herpes (HSV VIRUS) with the help of his powerful and effective herbal medication which I took for only two weeks, and I got a good result being cured from the herpes disease. If you are out there diagnosed or suffering from the herpes virus you can reach out to Herbal doctor Kham for help in getting rid of your herpes virus forever just the way he helped me got rid of mine; His email address is dr.khamcaregiver@gmail.com or for his quick response to you, you can reach him on WhatsApp with +2348159922297. The medical industry/Big Pharmacies make huge profits off treatments and modern drugs/medicines that can't even get the herpes virus cured. That's why they don't want you to know the cure. Aaron Traywick had a cure for HIV and herpes and he turned up dead like a week later, even Nipsey Hussell was murdered along with Lisa Left Eye Lopez by the US Government simply because these people were doing a research on how Dr Sebi makes herb for the cure to herpes virus and HIV. The Doctor Sebi in question was also killed by the US Government just because he was having the cure to herpes and HIV. Don't you find that fishy?
I was cured of HIV with the use of natural herbs. My name is Alandre and I'm from Texas. I love herbs so much. Most times, injection and drugs are just a waste of time. I was cured, I suffered from HIV for 13 years but with the help of Dr. Mark herbal medicine, I was cured within a few weeks of drinking the herbs he sent to me through courier delivery service. This same doctor also cured my Aunty from herpes, as soon as I heard she had herpes, I quickly refer her to Dr.Mark and she was cured too after drinking his herbs.I have referred a lot of people to Dr. Mark and they were all cured from their various illness. Have you taken herbs before?. You have spent so much money on drugs,injections,surgeries etc and yet you have no good result to show for it. Contact Dr. Mark now, he is a herbalist doctor, Dr. Mark has herbs that cures Hiv, Herpes, diabetics, asthma, hepatitis, STD, cancer, chronic, etc. Contact Dr Mark through his Email address on: blessedlovetemple@gmail.com Please share the good news to other people once you are cured.
I am here to give my testimony about Dr Ebhota who helped me.. i want to inform the public how i was cured from (HERPES SIMPLEX VIRUS) by salami, i visited different hospital but they gave me list of drugs like Famvir, Zovirax, and Valtrex which is very expensive to treat the symptoms and never cured me. I was browsing through the Internet searching for remedy on HERPES and i saw comment of people talking about how Dr Ehbota cured them. when i contacted him he gave me hope and send a Herbal medicine to me that i took for just 2 weeks and it seriously worked for me, my HERPES result came out negative. I am so happy as i am sharing this testimony. My advice to you all who thinks that there is no cure for herpes that is Not true just contact him and get cure from Dr Ebhota healing herbal cure of all kinds of sickness you may have like (1) CANCER,(2) DIABETES,(3) HIV&AIDS,(4) URINARY TRACT INFECTION,(5) CANCER,(6) IMPOTENCE,(7) BARENESS/INFERTILITY(8) DIARRHEA(9) ASTHMA(10)SIMPLEX HERPES AND GENITAL(11)COLD SOREHERPES. he also cure my friend from cervical cancer Email: drebhotasoultion@gmail.com or whatsapp him on +2348089535482
A GREAT SPELL CASTER (DR. EMU) THAT HELP ME BRING BACK MY EX GIRLFRIEND.
Am so happy to testify about a great spell caster that helped me when all hope was lost for me to unite with my ex-girlfriend that I love so much. I had a girlfriend that love me so much but something terrible happen to our relationship one afternoon when her friend that was always trying to get to me was trying to force me to make love to her just because she was been jealous of her friend that i was dating and on the scene my girlfriend just walk in and she thought we had something special doing together, i tried to explain things to her that her friend always do this whenever she is not with me and i always refuse her but i never told her because i did not want the both of them to be enemies to each other but she never believed me. She broke up with me and I tried times without numbers to make her believe me but she never believed me until one day i heard about the DR. EMU and I emailed him and he replied to me so kindly and helped me get back my lovely relationship that was already gone for two months.
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