A rare case of pyomyositis complicated by compartment syndrome caused by ST30–staphylococcal cassette chromosome mec type IV methicillin-resistant Staphylococcus aureus

Abstract

Diseases caused by community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA) are frequently associated with skin and soft tissue infections. However, unusual life-threatening infections in immunocompetent children and young adults have increasingly been reported, such as necrotizing fasciitis, pyomyositis, septic throm bophlebitis of the extremities, rapidly progressive and necrotizing pneumonia, acute hematogeneous osteomyelitis, septic thrombophlebitis, and Waterhouse-Friderichsen syn drome. In the case reported here, we describe a rare case of traumatic pyomyositis complicated with compartment syndrome in an immunocompetent 8-year-old child. Using staphylococcal cassette chromosome mec typing, pulsed field gel electrophoresis and multilocus sequence typing, it was found that the CA-MRSA isolate recovered belonged to ST30–staphylococcal cassette chromosome mec type IV lineage. In addition, polymerase chain reaction amplifica tions showed that this isolate was a Panton-Valentine leucocidin-producer CA-MRSA and also harbors the enterotoxin gene cluster locus (egc). Therefore, it is important that physicians be aware that CA-MRSA must be considered in case of deep skeletal muscle infections complicated with compartment syndrome