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Disseminated staphylococcal infection in a 5-year-old child

This 5-year-old child from Kurnool was transported to our Pediatric Intensive Care department in view of severe sepsis (blood stream infection), deep vein thrombosis of left leg (blood clot in the blood vessels), cellulitis, pyomyositis and osteomyelitis of left femur (infection of skin/soft tissue and muscles and bone) and peripheral septic pulmonary emboli (seedling of small clots in the peripheral blood vessels of the lung). Because of his underlying severe infection due to Staphylococcus, he also developed infection of the lining surrounding the heart (suppurative pericarditis), requiring a drain to remove the fluid (pericardial pigtail). He had a prolonged stay in the PICU due to multifocal infection (skin/heart/blood/lungs and bone) and subsequently underwent surgery for his bone infection.

The child required to be on the ventilator for 4 days and subsequently was on high flow oxygen for 2 weeks requiring integrated complex ICU care and dedicated nursing care, which helped him go back home with prolonged antibiotic therapy. An integrated multi-disciplinary approach involving pediatric intensivists, pediatric cardiologists and pediatric orthopedicians helped the child fight and overcome this overwhelming infection which could be fatal. Staphylococci are bacteria that are present in the environment and as normal flora of humans and animals, and they are resistant to heat and drying. These bacteria cause direct tissue invasion causing skin infection, pneumonia (infection in the lungs), infection of the bone and heart and a tendency to form blood clots. Staphylococcal infection acquired from community can affect healthy children and is a recognized cause of multifocal infection with high mortality rate due to direct bacteria invasion or toxin production and morbidity. Early recognition, prompt diagnosis, appropriate antimicrobials are essential in managing these sick children.

Dr. Anupama Yerra

Senior Consultant – Pediatric Intensivist and Pediatrician

Rainbow Children’s Hospital, Banjara Hills