MRSA Induced Septic Embolism in an Intravenous Drug User: How to Diagnose and Manage Septic Embolism

Abstract

A septic embolism occurs when an underlying infection causes a thrombus in a blood vessel to embolize and occlude a different blood vessel in the body. Since the embolus can travel to many different organs and cause ischemia, it can present with different symptoms and can cause life-threatening complications such as a pulmonary embolism. Due to this, it is essential to quickly recognize septic embolism in the Emergency Department and effectively treat the patient. This case report discusses a 47-year-old intravenous drug user male patient who presented with a constant sharp mid-upper back pain, tachycardia, and a heart murmur. This patient was started on IV antibiotics and imaged with a cardiac echo and computed tomography (CT) scan. Eventually, the diagnosis of Methicillin Resistant Staphylococcus aureus (MRSA) septic embolism was confirmed, and the patient was treated effectively with vancomycin. As there are multiple different diagnoses that present in a similar way, such as aortic dissection or bacterial endocarditis, looking at associated symptoms and using imaging can be useful to developing the final diagnosis. CT scans and positron emission tomography (PET) imaging are commonly used imaging techniques that are used to support and confirm the diagnosis of a septic embolism. Effective treatment involves the use of antibiotics (vancomycin, linezolid, and daptomycin) to treat the underlying MRSA infection and supportive care for any additional symptoms that the patient is experiencing. Leaving a patient undiagnosed with a septic embolism is associated with numerous additional complications; thus, it is necessary to quickly diagnose and treat this condition. A thorough examination of this case study will give a unique presentation of MRSA induced septic embolism in hopes of identifying and treating patients with this diagnosis.