OBJECTIVE: This case report aims to raise awareness in chiropractic physicians of the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in adolescents who participate in sports activities and to alert the chiropractic physician of the necessity to consider potential diagnoses that are not within their typical clinical heuristic. CLINICAL FEATURES: A 16-year-old adolescent girl entered the clinic with a complaint of left knee pain that had an insidious onset during her involvement in sports activities. Later that same day, her knee became enlarged, red, and had pustular formations with a discharge. She was taken to an urgent care facility and subsequently diagnosed with MRSA. Her history included treatment of a left knee musculoskeletal condition 6 weeks prior to which she had responded favorably. INTERVENTIONS AND OUTCOMES: She was treated medically with an aggressive course of antibiotic therapy and excision of the furuncle. The chiropractic physician played a role in patient education and notifying local school authorities of the case. CONCLUSION: Doctors of chiropractic must prepare themselves for the unexpected and remain open to diagnostic possibilities outside of the normal scope of practice. Knee pain or cellulitis of any type may require additional diagnostic and patient care protocols to make the correct diagnosis. With the incidence of community-acquired MRSA increasing at an alarming rate, it is certainly a diagnosis doctors of chiropractic should be aware of when treating patients, especially those involved in sports activities.
OBJECTIVE: This case report aims to raise awareness in chiropractic physicians of the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in adolescents who participate in sports activities and to alert the chiropractic physician of the necessity to consider potential diagnoses that are not within their typical clinical heuristic. CLINICAL FEATURES: A 16-year-old adolescent girl entered the clinic with a complaint of left knee pain that had an insidious onset during her involvement in sports activities. Later that same day, her knee became enlarged, red, and had pustular formations with a discharge. She was taken to an urgent care facility and subsequently diagnosed with MRSA. Her history included treatment of a left knee musculoskeletal condition 6 weeks prior to which she had responded favorably. INTERVENTIONS AND OUTCOMES: She was treated medically with an aggressive course of antibiotic therapy and excision of the furuncle. The chiropractic physician played a role in patient education and notifying local school authorities of the case. CONCLUSION: Doctors of chiropractic must prepare themselves for the unexpected and remain open to diagnostic possibilities outside of the normal scope of practice. Knee pain or cellulitis of any type may require additional diagnostic and patient care protocols to make the correct diagnosis. With the incidence of community-acquired MRSA increasing at an alarming rate, it is certainly a diagnosis doctors of chiropractic should be aware of when treating patients, especially those involved in sports activities.
Authors: Sophia V Kazakova; Jeffrey C Hageman; Matthew Matava; Arjun Srinivasan; Larry Phelan; Bernard Garfinkel; Thomas Boo; Sigrid McAllister; Jim Anderson; Bette Jensen; Doug Dodson; David Lonsway; Linda K McDougal; Matthew Arduino; Victoria J Fraser; George Killgore; Fred C Tenover; Sara Cody; Daniel B Jernigan Journal: N Engl J Med Date: 2005-02-03 Impact factor: 91.245
Authors: Elizabeth M Begier; Kasia Frenette; Nancy L Barrett; Pat Mshar; Susan Petit; Dave J Boxrud; Kellie Watkins-Colwell; Sheila Wheeler; Elizabeth A Cebelinski; Anita Glennen; Dao Nguyen; James L Hadler Journal: Clin Infect Dis Date: 2004-10-26 Impact factor: 9.079