A case of methicillin resistant staphylococcus aureus enterocolitis associated with toxic shock syndrome

We report the case of a young woman with MRSA enterocolitis associated with toxic shock syndrome. She improved dramatically after commencing enteral vancomycin when a pure growth of MRSA was obtained from a faecal swab. This swab was only tested for Staphylococcus aureus and s.aureus as it was believed to be of ‘facial’ origin in the laboratory. Such cases will be missed unless specific testing of faeces for s. aureus is requested. Case Report A 25 year old female was admitted with a 4 day history of central colicky abdominal pain radiating to the right iliac fossa, hot sweats, fever, bilious vomiting and diarrhoea. She described an 8-year history of episodic non-specific abdominal pain. A previous ultrasound scan had revealed an ovarian cyst thought not to be causative. These symptoms had previously been attributed to urinary tract infection and constipation. She was a non-smoker, never consumed alcohol and medication comprised simple analgesics and the oral contraceptive.