Abstract
To the Editor: Methicillin-resistant Staphylococcus aureus (MRSA) represents a major cause of hospital-, community- and livestock-acquired infections that are increasingly difficult to manage (1–3). Detection and identification of MRSA by culture and nucleic acid–based methods is challenged by heterogeneous penicillin-binding protein 2a (PBP2a) expression and variability of the staphylococcal cassette chromosome (SCCmec) elements. Recently, a new SCCmec element (XI) carried in bovine and human isolates was described (4,5). This SCCmec element contains a novel mecA homolog, designated mecALGA251, that is not detectable by usual mecA-specific PCR approaches and PBP2a agglutination tests. Garcia-Alvarez et al. reported this novel mecA homolog exhibited 70% identity at DNA level to the mecA gene, and suggested these strains were transmitted from livestock to humans (4).
Highlights
Intraocular involvement is associated with serious consequences, frequently leading to eye enucleation; 1 case series described eventual enucleation in 50% of reported patients who did not die from disseminated coccidioidal infection [2]
The optimal systemic antifungal therapy for intraocular coccidioidal infection is unclear, fluconazole is the drug of choice for extrapulmonary coccidioidomycosis, including meningitis [3]
Gabrielian and Hariprasad [8] described an immunocompetent patient with treated and stable nonocular disseminated coccidioidomycosis who showed development of new vitritis and choroiditis 8 weeks into high-dose fluconazole therapy; his intraocular disease resolved within 2–4 weeks of transition to voriconazole
Summary
Citation for published version (APA): Kriegeskorte, A., Ballhausen, B., Idelevich, E. Intraocular involvement is associated with serious consequences, frequently leading to eye enucleation; 1 case series described eventual enucleation in 50% of reported patients who did not die from disseminated coccidioidal infection [2]. The optimal systemic antifungal therapy for intraocular coccidioidal infection is unclear, fluconazole is the drug of choice for extrapulmonary coccidioidomycosis, including meningitis [3].
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