Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Mar 9, 2024; 13(1): 87459
Published online Mar 9, 2024. doi: 10.5492/wjccm.v13.i1.87459
Community-acquired multidrug-resistant pneumonia, bacteraemia, and infective endocarditis: A case report
Basavaraj Jatteppanavar, Arnab Choudhury, Prasan Kumar Panda, Mukesh Bairwa
Basavaraj Jatteppanavar, Arnab Choudhury, Prasan Kumar Panda, Mukesh Bairwa, Department of Medicine, All India Institute of Medical Sciences, Rishikesh 249203, India
Author contributions: Jatteppanavar B and Choudhury A contributed equally to this work; Jatteppanavar B, Choudhury A, Bairwa M, and Panda PK designed the research study, performed the research, and critically reviewed the manuscript; Jatteppanavar B and Choudhury A analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient in the study.
Conflict-of-interest statement: There are no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Prasan Kumar Panda, MBBS, MD, Associate Professor, Department of Medicine, All India Institute of Medical Sciences, Veer Bhadra Road, Rishikesh, Uttarkhand, 249203, India. motherprasanna@rediffmail.com
Received: August 12, 2023
Peer-review started: August 12, 2023
First decision: September 28, 2023
Revised: October 3, 2023
Accepted: December 4, 2023
Article in press: December 4, 2023
Published online: March 9, 2024
Processing time: 201 Days and 2.3 Hours
Abstract
BACKGROUND

The prevalence of multidrug-resistant (MDR) bacteria has increased globally, with extensive drug-resistant (XDR) bacteria posing a threat to patients.

CASE SUMMARY

This case report describes a young man admitted for suspected tropical fever infections who experienced rapid deterioration in health. Despite negative results for tropical fever infections, he had neutrophilic leucocytosis, acute kidney injury, and chest imaging findings suggestive of bilateral consolidations. On day two, he was diagnosed with infective endocarditis with possible rheumatic heart disease and MDR methicillin-resistant Staphylococcus aureus bacteraemia, and community-acquired pneumonia. Despite treatment with broad-spectrum antibiotics, he did not respond and succumbed to death on day five.

CONCLUSION

This case highlights that clinicians/public should be aware of MDR community-acquired pneumonia, bacteraemia, and endocarditis which ultimately culminate in high rates of morbidity and mortality. Early identification of pathogenic strain and prompt antibiotic treatment are a mainstay for the management and prevention of early fatalities. Simultaneously, route cause analysis of community-acquired MDR/XDR pathogens is a global need.

Keywords: Antibiotic resistance; Community-acquired infections; Infective endocarditis; Methicillin-resistant staphylococcus aureus; Rheumatic heart disease; Case report

Core Tip: A case of community-acquired multidrug-resistant methicillin-resistant Staphylococcus aureus infection leading to death is reported. The detection of CTX-M, VIM, NDM, mecA/C, and MREJ genes in microbial gene testing suggests that the patient was infected with MDR bacteria.