Septic Vasculitis as a Manifestation of Invasive Infection by Community-Acquired Methicillin- Resistant Staphylococcus aureus: A Pediatric Case

Abstract

Septic vasculitis (SV) is an uncommon complication of bacterial sepsis, characterized by inflammation and thrombosis of small- and medium-sized blood vessels. While it is commonly associated with meningococcemia, a few cases related to Staphylococcus aureus have been reported. Presented is the case of a previously healthy adolescent who developed SV as an initial manifestation of community-acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) bacteremia. The patient presented with fever, abdominal pain, and purpuric skin lesions, without any known exposure to typical risk factors. Initial clinical suspicion included loxoscelism-a necrotic arachnidism caused by Loxosceles spider bites-based on initial skin lesion morphology. However, further evaluation ruled out loxoscelism, autoimmune etiologies and confirmed MRSA infection through blood cultures and histopathologic analysis of a skin biopsy confirmed septic vasculitis. Imaging revealed secondary infectious foci in the spleen, kidneys, and bone, though no surgical intervention was necessary. The patient was manage with targeted antibiotic therapy, resulting in complete clinical recovery. This case underscores the importance of recognizing septic vasculitis as a rare but serious initial manifestation of invasive bacterial infection in otherwise healthy children. It highlights the diagnostic value of skin findings in febrile illnesses and emphasizes the need for prompt and comprehensive etiological investigation.