J Menopausal Med.  2016 Aug;22(2):118-121. 10.6118/jmm.2016.22.2.118.

Vulvar Abscess Caused by Methicillin-resistant Staphylococcus Aureus (MRSA) in a Postmenopausal Woman

• Kim TH
• Seap B
• Kim SA
• Heo GE

• KMID: 2365468
• DOI: http://doi.org/10.6118/jmm.2016.22.2.118

Abstract

Infections of the vulva can present a complex differential to the gynecologist, ranging from superficial skin infections to lifethreatening necrotizing fasciitis. Recognition and timely treatment remain universal to skin and soft-tissue infections as the subcutaneous anatomy of the vulva can facilitate rapid spread to other tissues with significant morbidity and mortality. Employing a multidisciplinary team approach to care for vulvar cellulitis and abscess can guide treatment from antibiotic therapies to more aggressive surgical debridement. In this report, we describe a case of vulvar abscess caused by Methicillin-resistant staphylococcus aureus (MRSA) in a postmenopausal woman with underlying diseases of bronchiectasis and atelectasis.

Keyword

Abscess; Cellulitis; Methicillin-resistant staphylococcus aureus; Postmenopause; Vulva

MeSH Terms

Abscess*
Bronchiectasis
Cellulitis
Debridement
Fasciitis, Necrotizing
Female
Humans
Methicillin Resistance*
Methicillin-Resistant Staphylococcus aureus*
Mortality
Postmenopause
Pulmonary Atelectasis
Skin
Vulva

Figure

• 

  Fig. 1 This postmenopausal woman has a vulvar abscess caused by Methicillin-resistant staphylococcus aureus (MRSA) involving the right labium major. Note the increased size, a background of erythema about the right labium major when compared with the left labium.

• 

  Fig. 2 This postmenopausal woman has a vulvar abscess caused by Methicillin-resistant staphylococcus aureus (MRSA) was received antibiotics combined with conservative therapy. Note the size and background color of both labia majorare similar on hospital admission day 11.

Reference

1. Lee SH, Kim TH, Lee HH, Lee WS, Chung SH. The clinical manifestation of the gynecologic emergency in postmenopausal women. J Korean Soc Menopause. 2012; 18:119–123.

2. Kim HK, Kang SY, Chung YJ, Kim JH, Kim MR. The recent review of the genitourinary syndrome of menopause. J Menopausal Med. 2015; 21:65–71.

3. Thurman AR, Satterfield TM, Soper DE. Methicillin-resistant Staphylococcus aureus as a common cause of vulvar abscesses. Obstet Gynecol. 2008; 112:538–544.

4. Bhide A, Nama V, Patel S, Kalu E. Microbiology of cysts/abscesses of Bartholin's gland: review of empirical antibiotic therapy against microbial culture. J Obstet Gynaecol. 2010; 30:701–703.

5. Kilpatrick CC, Alagkiozidis I, Orejuela FJ, Chohan L, Hollier LM. Factors complicating surgical management of the vulvar abscess. J Reprod Med. 2010; 55:139–142.

6. Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014; 59:e10–e52.

7. Reichman O, Sobel JD. MRSA infection of buttocks, vulva, and genital tract in women. Curr Infect Dis Rep. 2009; 11:465–470.

8. Park J, Kim TH, Lee HH, Lee W, Chung SH. Lichen sclerosus in a post-menopausal woman: a case report. J Korean Soc Menopause. 2012; 18:70–73.

9. Fadiel A, Lee HH, Demir N, Richman S, Iwasaki A, Connell K, et al. Ezrin is a key element in the human vagina. Maturitas. 2008; 60:31–41.

10. Lee HH, Kim TH, Park J, Lee A, Park Y, Byun DW, et al. Expression of ezrin in vagina cells of postmenopausal rats after dietary administration of omega-3 Fatty Acid formula. J Menopausal Med. 2014; 20:97–103.