Concurrent Methicillin-Resistant Staphylococcus aureus Septicemia and Thyroid Abscess in a Young Male with Dengue

Author(s): Durga Shankar Meena, Deepak Kumar*, Gopal Krishana Bohra, Mahendra kumar Garg, Naresh Midha, Taruna Yadav, Prakrati Yadav

Journal Name: Infectious Disorders - Drug Targets
Formerly Current Drug Targets - Infectious Disorders

Volume 21 , Issue 1 , 2021


Become EABM
Become Reviewer
Call for Editor

Graphical Abstract:


Abstract:

Background: Dengue fever is an arthropod-borne viral infection with a very high incidence rate in Southeast Asia. Most patients present with self-limiting febrile illness, while some patients may develop complications like acute kidney injury, acute liver failure, myocarditis or Guillain– Barre syndrome. The coexistence of Dengue and MRSA (Methicillin-resistant Staphylococcus aureus ) is rarely reported in the literature.

Case: A 28-year-old male is presented with high-grade fever, polyserositis and thrombocytopenia. The patient was treated symptomatically for dengue infection. During the course of hospitalization, patient developed neck swelling (thyroid abscess) and left forearm abscess. MRSA was isolated from blood culture and pus, and successfully treated with iv antibiotics (Vancomycin).

Conclusion: High anticipation and vigilance are required to detect concurrent bacteremia in dengue patients. Early recognition of warning signs with readily antibiotic therapy is important to prevent mortality and morbidity in these patients. Our report also highlights the MRSA as a rare cause of thyroid abscess, with only 5 cases reported in the literature so far.

Keywords: Dengue, Staphylococcus aureus, drug resistance, thyroid abscess, coinfection, thrombocytopenia.

[1]
Trunfio, M; Savoldi, A; Viganò, O; d'Arminio, M.A. Bacterial coinfections in dengue virus disease: what we know and what is still obscure about an emerging concern. Infection, 2017, 45(1), 1-10.
[http://dx.doi.org/10.1007/s15010-016-0927-6]
[2]
Pérez Rodríguez, N.M.; Galloway, R.; Blau, D.M.; Traxler, R.; Bhatnagar, J.; Zaki, S.R.; Rivera, A.; Torres, J.V.; Noyd, D.; Santiago-Albizu, X.E.; Rivera García, B.; Tomashek, K.M.; Bower, W.A.; Sharp, T.M. Case series of fatal Leptospira spp./dengue virus co-infections-Puerto Rico, 2010-2012. Am. J. Trop. Med. Hyg., 2014, 91(4), 760-765.
[http://dx.doi.org/10.4269/ajtmh.14-0220] [PMID: 25092820]
[3]
Chai, L.Y.; Lim, P.L.; Lee, C.C.; Hsu, L.Y.; Teoh, Y.L.; Lye, D.C.; Krishnan, P.; Leo, Y.S. Cluster of Staphylococcus aureus and dengue co-infection in Singapore. Ann. Acad. Med. Singapore, 2007, 36(10), 847-850.
[PMID: 17987236]
[4]
Srinivasaraghavan, R.; Narayanan, P.; Kanimozhi, T. Culture proven Salmonella typhi co-infection in a child with Dengue fever: a case report. J. Infect. Dev. Ctries., 2015, 9(9), 1033-1035.
[http://dx.doi.org/10.3855/jidc.5230] [PMID: 26409747]
[5]
Ehelepola, N.D.B.; Rajapaksha, R.K.G.M.; Dhanapala, D.M.U.B.; Thennekoon, T.D.K.; Ponnamperuma, S. Concurrent methicillin-resistant Staphylococcus aureus septicemia and pyomyositis in a patient with dengue hemorrhagic fever: a case report. BMC Infect. Dis., 2018, 18(1), 99.
[http://dx.doi.org/10.1186/s12879-018-3012-1] [PMID: 29486726]
[6]
Sunderalingam, V.; Kanapathipillai, T.; Edirisinghe, P.A.; Dassanayake, K.M.; Premawansa, I.H. Dengue Viral Myositis Complicated with Rhabdomyolysis and Superinfection of Methicillin-Resistant Staphylococcus aureus. Case Rep. Infect. Dis., 2013, 2013194205
[http://dx.doi.org/10.1155/2013/194205] [PMID: 23476836]
[7]
Mutheneni, S.R.; Morse, A.P.; Caminade, C.; Upadhyayula, S.M. Dengue burden in India: recent trends and importance of climatic parameters. Emerg. Microbes Infect., 2017, 6(8)e70
[http://dx.doi.org/10.1038/emi.2017.57] [PMID: 28790459]
[8]
Thein, T.L.; Ng, E.L.; Yeang, M.S.; Leo, Y.S.; Lye, D.C. Risk factors for concurrent bacteremia in adult patients with dengue. J. Microbiol. Immunol. Infect., 2017, 50(3), 314-320.
[http://dx.doi.org/10.1016/j.jmii.2015.06.008] [PMID: 26338309]
[9]
See, K.C.; Phua, J.; Yip, H.S.; Yeo, L.L.; Lim, T.K. Identification of concurrent bacterial infection in adult patients with dengue. Am. J. Trop. Med. Hyg., 2013, 89(4), 804-810.
[http://dx.doi.org/10.4269/ajtmh.13-0197] [PMID: 23980129]
[10]
Lee, I.K.; Liu, J.W.; Yang, K.D. Clinical characteristics and risk factors for concurrent bacteremia in adults with dengue hemorrhagic fever. Am. J. Trop. Med. Hyg., 2005, 72(2), 221-226.
[http://dx.doi.org/10.4269/ajtmh.2005.72.221] [PMID: 15741560]
[11]
Chen, C.M.; Chan, K.S.; Chao, H.C.; Lai, C.C. Diagnostic performance of procalcitonin for bacteremia in patients with severe dengue infection in the intensive care unit. J. Infect., 2016, 73(1), 93-95.
[http://dx.doi.org/10.1016/j.jinf.2016.03.013] [PMID: 27033048]
[12]
Araújo, S.A.; Moreira, D.R.; Veloso, J.M.; Silva, J.O.; Barros, V.L.; Nobre, V. Fatal Staphylococcal infection following classic Dengue fever. Am. J. Trop. Med. Hyg., 2010, 83(3), 679-682.
[http://dx.doi.org/10.4269/ajtmh.2010.10-0009] [PMID: 20810838]
[13]
Arora, S.; Devi, P.; Arora, U.; Devi, B. Prevalence of Methicillin- resistant Staphylococcus aureus (MRSA) in a tertiary care hospital in northern India. J. Lab. Physicians, 2010, 2(2), 78-81.
[http://dx.doi.org/10.4103/0974-2727.72154] [PMID: 21346901]
[14]
D’Souza, N.; Rodrigues, C.; Mehta, A. Molecular characterization of methicillin-resistant Staphylococcus aureus with emergence of epidemic clones of sequence type (ST) 22 and ST 772 in Mumbai, India. J. Clin. Microbiol., 2010, 48(5), 1806-1811.
[http://dx.doi.org/10.1128/JCM.01867-09] [PMID: 20351212]
[15]
van de Weg, C.A.; Koraka, P.; van Gorp, E.C.; Mairuhu, A.T.; Supriatna, M.; Soemantri, A.; van de Vijver, D.A.; Osterhaus, A.D.; Martina, B.E. Lipopolysaccharide levels are elevated in dengue virus infected patients and correlate with disease severity. J. Clin. Virol., 2012, 53(1), 38-42.
[http://dx.doi.org/10.1016/j.jcv.2011.09.028] [PMID: 22014848]
[16]
Moi, M.L.; Takasaki, T.; Kurane, I. Human antibody response to dengue virus: implications for dengue vaccine design. Trop. Med. Health, 2016, 44, 1.
[http://dx.doi.org/10.1186/s41182-016-0004-y] [PMID: 27398060]
[17]
Querenet, M.; Danjoy, M.L.; Mollereau, B.; Davoust, N. Expression of dengue virus NS3 protein in Drosophila alters its susceptibility to infection. Fly (Austin), 2015, 9(1), 1-6.
[http://dx.doi.org/10.1080/19336934.2015.1072662] [PMID: 26267447]
[18]
Kamaladasa, A.; Gomes, L.; Jeewandara, C.; Shyamali, N.L.; Ogg, G.S.; Malavige, G.N. Lipopolysaccharide acts synergistically with the dengue virus to induce monocyte production of platelet activating factor and other inflammatory mediators. Antiviral Res., 2016, 133, 183-190.
[http://dx.doi.org/10.1016/j.antiviral.2016.07.016] [PMID: 27476044]
[19]
Lethert, K.; Bowerman, J.; Pont, A.; Earle, K.; Garcia-Kennedy, R. Methicillin-resistant Staphylococcus aureus suppurative thyroiditis with thyrotoxicosis. Am. J. Med., 2006, 119(11), e1-e2.
[http://dx.doi.org/10.1016/j.amjmed.2006.03.016] [PMID: 17071148]
[20]
Elorza, J.L.; Echenique-Elizonda, M. Acute suppurative thyroiditis. J. Am. Coll. Surg., 2002, 195(5), 729-730.
[http://dx.doi.org/10.1016/S1072-7515(02)01322-4] [PMID: 12437264]
[21]
Brook, I. Role of methicillin-resistant Staphylococcus aureus in head and neck infections. J. Laryngol. Otol., 2009, 123(12), 1301-1307.
[http://dx.doi.org/10.1017/S0022215109990624] [PMID: 19664316]
[22]
Cabizuca, C.A.; Bulzico, D.A.; de Almeida, M.H.; Conceição, F.L.; Vaisman, M. Acute thyroiditis due to septic emboli derived from infective endocarditis. Postgrad. Med. J., 2008, 84(994), 445-446.
[http://dx.doi.org/10.1136/pgmj.2008.067850] [PMID: 18832408]
[23]
Yedla, N.; Pirela, D.; Manzano, A.; Tuda, C.; Lo Presti, S. Thyroid Abscess: Challenges in Diagnosis and Management. J. Investig. Med. High Impact Case Rep., 2018, 62324709618778709
[http://dx.doi.org/10.1177/2324709618778709] [PMID: 29854858]


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 21
ISSUE: 1
Year: 2021
Published on: 12 March, 2020
Page: [156 - 160]
Pages: 5
DOI: 10.2174/1871526520666200312160701
Price: $65

Article Metrics

PDF: 18
HTML: 1