Community-acquired multidrug-resistant pneumonia, bacteraemia, and infective endocarditis: A case report

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.