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Methicillin-resistant Staphylococcus aureus (MRSA) sepsis complicated by warm autoimmune haemolytic anaemia secondary to antimicrobial therapy
  1. Jorge Verdecia,
  2. Jarelys Hernandez,
  3. Christopher Izzo,
  4. Elisa Sottile and
  5. Carmen Isache
  1. Department of Internal Medicine, University of Florida Health at Jacksonville, Jacksonville, Florida, USA
  1. Correspondence to Dr Jorge Verdecia, jorge.verdecia{at}


A 61-year-old Caucasian woman presented to the emergency room complaining of left-sided chest pain and altered mentation for 3 days. Her medical history included liver cirrhosis and coronary artery disease. On admission, she was found to have methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia. Due to a decline in mental status, a lumbar puncture was performed and cerebrospinal fluid cultures grew MRSA. She was treated initially with vancomycin. Ceftaroline was later added, due to the high burden of disease and difficulty in clearing her infection. After initiation of ceftaroline, bacteraemia cleared and mental status improved, however, she developed haemolytic anaemia. Ceftaroline was stopped and vancomycin continued. Staphylococcal meningitis is a rare occurrence, estimated at a rate of only 1%–10% of all bacterial meningitis cases. Ceftaroline seems to be a suitable option for disseminated MRSA infection, including MRSA meningitis, when the clinical response to vancomycin is inadequate. Further studies are warranted in order to establish adequate dosing while avoiding adverse effects.

  • infections
  • drugs: infectious diseases
  • meningitis
  • pneumonia (infectious disease)
  • unwanted effects / adverse reactions

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  • Contributors JV, JH, CIz, ES, and CIs: contributed to conception, design, acquisition of data, analysis, interpretation of data, as well as drafting the article and revising it critically for important intellectual content. Authors have agreed on the final approval of the version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Next of kin consent obtained.

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