Camargo, Carlos Henrique [UNESP]Cunha, Maria de Lourdes Ribeiro de Souza da [UNESP]Bonesso, Mariana Fávero [UNESP]Da Cunha, Fabiana Picoli [UNESP]Barbosa, Alexandre Naime [UNESP]Fortaleza, Carlos Magno Castelo Branco [UNESP]2014-05-272014-05-272013-07-01Diagnostic Microbiology and Infectious Disease, v. 76, n. 3, p. 372-374, 2013.0732-88931879-0070http://hdl.handle.net/11449/75761Even though community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA) was described a decade ago, reports from Brazil are scarce and cases occurred in large urban centers. We report MRSA sepsis in a 16-year-old male from a small town and who had no history of exposure to healthcare or recent travel. After trauma during a soccer match, he presented swelling in the right thigh, which evolved in a month to cellulitis complicated by local abscess, orchitis and pneumonia. The patient presented severe sepsis, with fever and respiratory failure. Laboratory findings included blood leukocyte counts above 40,000/mm3 and thrombocytopenia. He was submitted to mechanical ventilation and therapy with vancomycin and imipenem. He had a slow but favorable response to therapy and was discharged after six weeks of hospitalization. MRSA grew from blood cultures and respiratory aspirates obtained before antimicrobial therapy. The isolate belonged to sequence type 5, spa type t311, harbored SCCmec type IV and genes for Panton-Valentine leukocidin and Enterotoxin A. The pulsed-field gel electrophoresis pattern was distinct from North American classic CA-MRSA clones. However, the sequence type and the spa type revealed that the clone belong to the same clonal complex isolated in Argentina. This is the first CA-MRSA infection reported in that region, with significant epidemiologic and clinical implications. © 2013 Elsevier Inc.372-374engCA-MRSAPanton-Valentine LeukocidinSCCmec type IVSystemic infectionalpha hemolysinbacterial enzymecefepimechloramphenicolciprofloxacinclindamycincotrimoxazoledalfopristin plus quinupristindeoxyribonucleaseenterotoxinenterotoxin aerythromycingentamicinimipenemlevofloxacinlinezolidPanton Valentine leukocidinphospholipasetriacylglycerol lipaseunclassified drugvancomycinabscessadolescentalleleappendicitisartificial ventilationbacterial genebacterial growthbacterial virulencebacterium culturebacterium isolationblood cultureBrazilcase reportcellulitiscommunicable diseasecomputer assisted tomographydifferential diagnosisdisease severitydrug responsedrug sensitivitydrug substitutiondrug withdrawalenzyme synthesisfevergene cassettegene identificationhip painhumanjaundicelung infiltratemalemecA genemethicillin resistant Staphylococcus aureusmethicillin resistant Staphylococcus aureus infectionminimum inhibitory concentrationmolecular cloningneutrophil countnonhumanorchitispneumoniapriority journalpulsed field gel electrophoresisremissionrespiratory failuresepsissoccersport injurysystemic diseasetachypneathrombocyte countthrombocytopeniatracheal aspiration procedureArtigo10.1016/j.diagmicrobio.2013.03.013WOS:000321026800023Acesso restrito2-s2.0-848791895410115647772315973