University of Wisconsin–Madison Medical College of Wisconsin

MRSA Septicemia With Septic Arthritis and Prostatic, Intraretinal, Periapical, and Lung Abscesses

Ryan A. Denu, PhD; Deval Patel, MD; Benjamin J. Becker, DO; Thomas Shiffler, MD; Peter Kleinschmidt, MD

WMJ. 2020;119(1):62-65.

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Introduction: Methicillin-resistant staphylococcus aureus (MRSA) bacteremia is a life-threatening illness and a major global health care problem. It can cause metastatic and complicated infections.

Case Presentation: A 58-year-old man with uncontrolled type 2 diabetes mellitus presented with altered mental status after a fall. He was found to have a hip fracture, diabetic ketoacidosis, and MRSA bacteremia. This was complicated by septic knee arthritis, prostatic abscess, intraretinal abscess, periapical abscesses, and pulmonary abscesses. He was treated with intravenous vancomycin and oral linezolid and eventually recovered.

Discussion: Severe metastatic MRSA infection was likely due, in part, to the patient’s uncontrolled diabetes, as he has no underlying immunodeficiency and was HIV negative. Prostatic abscesses are a relatively rare occurrence that typically develop in immunocompromised patients.

Conclusion: This case is an interesting confluence of sequelae of MRSA bacteremia and reinforces the necessity for clinicians to be diligent when evaluating a patient with a suspected prostatic abscess.

Author Affiliations: Medical Scientist Training Program, School of Medicine and Public Health (SMPH), University of Wisconsin-Madison, Madison, Wis (UW-Madison) (Denu); Department of Medicine, SMPH, UW-Madison, Madison, Wis (Denu, Patel, Shiffler, Kleinschmidt); Department of Anesthesiology, SMPH, UW-Madison, Madison, Wis (Becker).
Corresponding Authors: Peter Kleinschmidt, MD, phone 608.242.6850, email; Thomas Shiffler, MD, 608.263.7500,
Consent: Informed consent was obtained from the patient for publication of this case report.
Financial Disclosures: None declared.
Funding/Support: Ryan A. Denu, PhD, is supported by National Institutes of Health awards F30CA203271 and T32GM008692.
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