Case history
Case history #1
A 21-year-old man presents complaining of a spider bite to his upper extremity that has now increased in size and tenderness. The lesion has a central ulceration with surrounding erythema. He was seen previously at a local urgent care centre and started on a cephalosporin. The lesion has worsened. [Figure caption and citation for the preceding image starts]: A common ulcerative skin lesion secondary to MRSA on a patient's armPublic Health Image Library, CDC website [Citation ends].
Case history #2
A 71-year-old woman with chronic renal failure presents to the emergency department after experiencing a fever of 40°C (104°F) and hypotension during dialysis. She was recently hospitalised for respiratory failure secondary to pneumonia and an acute exacerbation of COPD.
Other presentations
MRSA can present in older patients as complicated urinary tract infections with dysuria, a fever and flank pain, weakness, and confusion. Not uncommonly, these patients are in a hospital or other healthcare setting in which they have urinary catheters inserted. Urinalysis is typically consistent with urinary tract infection, and sensitivities on culture show MRSA. Patients may have concomitant bacteraemia.
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