Abstract
CONTEXT Coagulase-negative staphylococci are common colonizers of the human skin and have become increasingly recognized as agents of clinically significant nosocomial infections. CASE REPORT The case of a 79-year-old male patient with multi-infarct dementia who presented systemic inflammatory response syndrome is reported. This was attributed to bacteremia due to Staphylococcus cohnii ssp. urealyticus, which was grown on blood cultures originating from an infected pressure ulcer. The few cases of Staphylococcus cohnii infection reported in the literature consist of bacteremia relating to catheters, surgical prostheses, acute cholecystitis, brain abscess, endocarditis, pneumonia, urinary tract infection and septic arthritis, generally presenting a multiresistant profile, with nearly 90% resistance to methicillin. CONCLUSIONS The reported case is, to our knowledge, the first case of true bacteremia due to Staphylococcus cohnii subsp. urealyticus caused by an infected pressure ulcer. It shows that this species may be underdiagnosed and should be considered in the differential diagnosis for community-acquired skin infections.
Highlights
Coagulase-negative staphylococci (CoNS) are common colonizers of the human skin and are the most frequent constituent of the normal flora at this site
CASE REPORT A 79-year-old male patient with a previous diagnosis of multiinfarct dementia and hypertension was admitted to the emergency department of Hospital Nossa Senhora da Conceição (HNSC) after an episode of malaise, shivering, fever, disorientation and hypoxemia, compatible with an episode of bacteremia, which was witnessed by a primary healthcare physician
A diagnosis of true bacteremia due to Staphylococcus cohnii ssp. urealyticus caused by an infected pressure ulcer was made
Summary
Coagulase-negative staphylococci (CoNS) are common colonizers of the human skin and are the most frequent constituent of the normal flora at this site. CASE REPORT A 79-year-old male patient with a previous diagnosis of multiinfarct dementia and hypertension was admitted to the emergency department of Hospital Nossa Senhora da Conceição (HNSC) after an episode of malaise, shivering, fever, disorientation and hypoxemia, compatible with an episode of bacteremia, which was witnessed by a primary healthcare physician. The patient was admitted to the emergency department with acute worsening of his baseline state of disorientation, which was fluctuating between drowsiness and agitation (diagnosed as delirium by the medical staff), tachycardia, tachypnea and mild fever, associated with a grade III infected sacral pressure ulcer (i.e. down to the superficial fascia) and pressure ulcers above both femoral trochanters (without signs of infection). An active search for the focus of the probable infection found sterile urine, no sign of recent lung infection and two positive samples from peripheral.
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