Fulminant arterial vasculitis as an unusual complication of disseminated staphylococcal disease due to the emerging CC1 methicillin-susceptible Staphylococcus aureus clone: a case report

BMC Infect Dis. 2019 Apr 3;19(1):302. doi: 10.1186/s12879-019-3933-3.

Abstract

Background: Staphylococcus aureus has emerged as a leading cause of invasive severe diseases with a high rate of morbidity and mortality worldwide. The wide spectrum of clinical manifestations and outcome observed in staphylococcal illness may be a consequence of both microbial factors and variability of the host immune response.

Case presentation: A 14-years old child developed limb ischemia with gangrene following S. aureus bloodstream infection. Histopathology revealed medium-sized arterial vasculitis. The causing strain belonged to the emerging clone CC1-MSSA and numerous pathogenesis-related genes were identified. Patient's genotyping revealed functional variants associated with severe infections. A combination of virulence and host factors might explain this unique severe form of staphylococcal disease.

Conclusion: A combination of virulence and genetic host factors might explain this unique severe form of staphylococcal disease.

Keywords: Case report; Genetic susceptibility; Polymorphism; S. aureus; Sepsis; Vasculitis; Virulence.

MeSH terms

  • Adolescent
  • Amputation, Surgical
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Brain / diagnostic imaging
  • Cefotaxime / pharmacology
  • Cefotaxime / therapeutic use
  • Clindamycin / pharmacology
  • Clindamycin / therapeutic use
  • Humans
  • Leg / surgery
  • Magnetic Resonance Imaging
  • Male
  • Methicillin / pharmacology
  • Shock, Septic / diagnosis
  • Shock, Septic / drug therapy
  • Staphylococcal Infections / complications
  • Staphylococcal Infections / diagnosis*
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / genetics*
  • Staphylococcus aureus / isolation & purification
  • Vasculitis / complications
  • Vasculitis / diagnosis*
  • Vasculitis / microbiology

Substances

  • Anti-Bacterial Agents
  • Clindamycin
  • Cefotaxime
  • Methicillin