RESUMO
Lower-extremity swelling is an uncommon presentation in a pediatric emergency department. Deep venous thrombosis is one of the common differential diagnoses in a patient with an underlying predisposing factor. We report a case of a previously healthy adolescent without any risk factor for thromboembolism presented with deep venous thrombosis. The pertinent literature is reviewed.
Assuntos
Edema/diagnóstico , Extremidade Inferior , Trombose Venosa/diagnóstico , Adolescente , Diagnóstico Diferencial , Edema/etiologia , Feminino , Humanos , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler Dupla , Trombose Venosa/complicaçõesRESUMO
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a serious problem in the community setting, primarily as a cause of skin and soft tissue infections. METHODS: A retrospective study based on the review of pediatric inpatients admitted to Lincoln Medical and Mental Health Center from March 2006 to February 2007 was performed. RESULTS: Eighteen (55%) of the thirty-three patients identified were infected with community associated (CA) MRSA. All patients had skin and soft tissue infections. Seventeen (94%) of eighteen CA-MRSA isolates were susceptible to trimethoprim-sulfamethoxazole and tetracycline, respectively, and eleven (61%) were susceptible to levofloxacin. CONCLUSIONS: Skin and soft tissue infections are the most common clinical manifestation of CA-MRSA in our population. The 55% prevalence of MRSA in our patients suggests reconsidering empirical antimicrobial choices. Surgical intervention is important in the management of these infections, and clindamycin resistance among CA-MRSA isolates should be monitored locally to determine if empiric therapy is appropriate.