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MRSA, Community Acquired, Emergency Medicine

Benjamin S. Heavrin Reviewed 06/2017
 


Basics

Description

  • Methicillin-resistant Staphylococcus aureus (MRSA) has historically been a pathogen endemic within healthcare settings, usually affecting the elderly and chronically ill. This strain...

Diagnosis

Signs and Symptoms

History

  • Skin and soft tissue infections:

    • Increasing redness

    • Pain

    • Warmth

    • Swelling

    • Fever

    • Chills

    • Malaise

  • Sepsis/pneumonia:

    • Weakness

    • Dyspnea

    • Fever

    • Rigors

    • Productive cough

    • Chest pain

  • Inquire ab...

Treatment

Pre-Hospital

  • Contact precautions for all providers if MRSA is suspected

  • IV access and fluid resuscitation if sepsis is suspected

Initial Stabilization/Therapy

Begin resuscitation and administer ...

Follow-Up

Disposition

Admission Criteria

  • Patients with signs/symptoms of bacteremia, progressive infection, or systemic illness should be admitted:

    • Fever, chills, lymphangitic streaking

  • Patients with unde...

Pearls and Pitfalls

  • CA-MRSA is the most common cause of skin and soft tissue infections seen in the ED.

  • CA-MRSA is a rare but serious cause of rapidly progressive pneumonia and sepsis.

  • Antibiotic resist...

Additional Reading

  • Frazee  BW, Lynn  J, Charlebois  ED, et al. High prevalence of methicillin-resistant Staphylococcus aureus in emergency department skin and soft tissue infections. Ann Emerg Med. &#...

Codes

ICD9

041.12 Methicillin resistant Staphylococcus aureus in conditions classified elsewhere and of unspecified site 

ICD10

  • A41.02 Sepsis due to Methicillin resistant Staphylococcus aureus

  • A49.02 Meth...

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