A Case of Methicillin-resistant Staphylococcus Aureus (MRSA) Enterocolitis Associated with Adhesional Ileus

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A 62-year-old male was admitted at our hospital with vomiting and abdominal pain, 4 months after an aorto-bifemoral bypass. A long tube was inserted because of the physiologic and radiologic evidence of intestinal obstruction. Spike fever and tachycardia developed on the 9th day of admission, together with increase of aqueous discharge through the long tube up to about 3, 000m<I>l</I>/day. Because the patients condition did not improve and paralytic ileus developed despite the fact that the tube reached the obstructing point of the intestine, laparotomy was performed on the 20<SUP>th</SUP> day of admission. A fibrous adhesion, which created the point of caliber change of the intestine, at 80cm oral to the ileal end was released. Because MRSA was isolated from the discharge through the long tube, the patient was started on vancomycin and recovered. MRSA enterocolitis associated with adhesional ileus is rare, but it is necessary to pay attention to the properties of the discharge from long tube. If MRSA enterocolitis is suspected, appropriate treatment should be promptly instituted before a bacteriological diagnosis is made.
日本腹部救急医学会の論文