Infect Chemother.  2013 Dec;45(4):441-445. 10.3947/ic.2013.45.4.441.

A Case of Acute Pyogenic Sacroiliitis and Bacteremia Caused by Community-Acquired Methicillin-Resistant Staphylococcus aureus

• Kim S
• Lee KL
• Baek HL
• Jang SJ
• Moon SM
• Cho YK

• KMID: 2170449
• DOI: http://doi.org/10.3947/ic.2013.45.4.441

Abstract

Pyogenic sacroiliitis is a rare osteoarticular infection, occurring most frequently in children and young adults. Diagnosis of the disease is challenging because of a general lack of awareness of the disease and its nonspecific signs and symptoms. Staphylococcus aureus is the most common causative bacteria in pyogenic sacroiliitis. Methicillin-resistant S. aureus (MRSA) has typically been considered a hospital-associated pathogen; however, community-acquired (CA)-MRSA infections are becoming increasingly common in Korea. We report the first domestic case of acute pyogenic sacroiliitis with abscess and bacteremia caused by CA-MRSA. The pathogen carried the type IV-A staphylococcal cassette chromosome mec (SCCmec) without the Panton-Valentine leukocidin (PVL) gene, and was identified as sequence type (ST) 72 by multilocus sequence typing.

Keyword

Community-acquired infections; Methicillin-resistant Staphylococcus aureus; Pyogenic sacroiliitis

MeSH Terms

Abscess
Bacteremia*
Bacteria
Child
Community-Acquired Infections
Diagnosis
Humans
Korea
Leukocidins
Methicillin Resistance*
Methicillin-Resistant Staphylococcus aureus*
Multilocus Sequence Typing
Sacroiliitis*
Staphylococcus aureus
Young Adult
Leukocidins

Figure

• 

  Figure 1 Contrast-enhanced T1-weighted magnetic resonance imaging of both hips shows infectious arthritis of the right sacroiliac joint associated with cellulitis and myositis with abscess formation (red arrow).

• 

  Figure 2 SCCmec typing of isolated MRSA (A) 100-bp marker, (B) patient's blood isolates, (C) SCCmec type II-positive control, (D) SCCmec type III-positive control, (E) SCCmec type IV-A-positive control, (F) negative control.

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