Esophago-pericardial Fistula Induced Community Acquired Methicillin Resistant Staphylococcus Aureus (CA-MRSA) Cardiac Tamponade - A Rare Case Report and Literature Review.

Pramod Theetha Kariyanna,Michael Ashamalla,Samy I Mcfarlane,Aarti Shenoy,Sudhanva Hegde,Jonathan D Marmur,Apoorva Jayarangaiah,Ronald Pedalino,Justina Ray

doi:10.12691/ajmcr-6-6-3

Abstract

Community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) infection is a matter of public health concern. The incidence of community acquired Staphylococcus aureus (CA-MRSA) is rising. To date only 12 cases of CA-MRSA pericarditis and seven cases of esophageal cancer related purulent pericarditis have been reported. We here present a 54 year old woman who presented with cardiac tamponade that was noted to be purulent and in whom esophagopericardial fistula secondary to squamous cell esophageal cancer was discovered subsequently. Purulent pericardial fluid subsequently grew MRSA. Patient succumbed despite appropriate management with antibiotics.

Highlights

The infection rates of hospital acquired methicillin resistant Staphylococcus aureus (MRSA) have been stable recently; in contrast, the incidence of community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) is increasing in alarming rates [1]
We present a case of a suppurative cardiac tamponade caused by Community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) pericarditis in a 54 year old African- American female
She was subsequently found to have squamous cell carcinoma of the esophagus that led to a fistula into the pericardium resulting in the development of CA-MRSA cardiac tamponade

Summary

Introduction

The infection rates of hospital acquired methicillin resistant Staphylococcus aureus (MRSA) have been stable recently; in contrast, the incidence of community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) is increasing in alarming rates [1]. CA-MRSA is a very rare cause of pericarditis and to date only 12 cases have been reported. We present a case of a suppurative cardiac tamponade caused by CA-MRSA pericarditis in a 54 year old African- American female. She was subsequently found to have squamous cell carcinoma of the esophagus that led to a fistula into the pericardium resulting in the development of CA-MRSA cardiac tamponade

Case Report

Discussion

Conclusion