Shazma Khan
Aga Khan University Hospital, Pakistan
Title: Methicillin-resistant Staphylococcus aureus: Case report of acute sinusitis with orbital extension in a pregnant lady
Biography
Biography: Shazma Khan
Abstract
Recognized since 1960s, methicillin-resistant Staphylococcus aureus (MRSA) has increasingly been recognized as a cause of soft tissue infections. Previously believed to be transmitted solely via health care systems in immunocompromised hosts, it is now believed that diff erent strains are responsible for spread of infection in immunocompetent individuals in community. Th is form is referred to as community acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) which is mainly associated with soft tissue abscesses and cellulitis. Acute sinusitis due to MRSA can be one of the deadest presentations of this infection as it can quickly lead to orbitocranial involvement with complications including blindness, brain abscess and death. Seriousness of MRSA infection increases manifold when the infection occurs in pregnant women. While still not known in developing countries, the prevalence of MRSA colonization in pregnant women in western world is stated to be 0.5-4%. Early suspicion of infection is the key to better prognosis. Appropriate antibiotics should be started without delay and early drainage of abscess, if any, should be the target. Delay in treatment, medical or surgical, may lead to serious consequences including death. We present here the case of a 34-year-oldlady who was 31 weeks’ pregnant and presented with one day history of severe right sided headache. She was found to have acute sinusitis that involved right orbit in less than 24 hours of presentation. A diagnosis of sinusitis secondary to CA-MRSA was made. Promptly managed with intravenous antibiotics and drainage of maxillary sinus abscess, the patient made remarkably complete recovery without any complications.