Joshua H.

Matthews

PATHOGENS

Matthews.josh@gmail.com

Monsters Inside Us

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Pathogens
Monsters Inside Us
JOSHUA H. MATTHEWS
BENEDICTINE UNIVERSITY

Author Note
Joshua H Matthews, Department of Public Health, Benedictine University.
Correspondences concerning this paper can be sent to Joshua Matthews at 1356 Bunker
Hill Blvd, Columbus Ohio 43220.
Contact: Matthews.josh@gmail.com

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Pathogens
Monsters Inside Us
A man in his late thirties was referred to a specialist bone infection service. He had
congenital hip dysplasia which had undergone bilateral hip replacements by the age of 21 years. In
his early thirties, the left prosthetic hip was replaced because of mechanical problems, with the right
side replaced the following year. A year later he developed bilateral discharging sinuses over the
hips and underwent several incision and drainage procedures.

My first suggestion for consideration would be Methicillin- resistant Staphylococcus

aureus (MRSA) as culprit. Alternative concerns for consideration may be Staph Infection
(Staphylococcus aureus) or Osteomyelitis (infection in the bone). These may or may not be
related to malpractice or medical neglect and are able to be contracted in other ways than the hip
replacement surgeries.

MRSA
Methicillin- resistant Staphylococcus aureus (MRSA) is a common pathogen that two in
100 carry. Staph infection, a related pathogen is even more common with one in three carrying it
without incident in their noses. MRSA is communicable and passed in most any personal item
shared such as towels, razors, or even touching skin of someone infected. This is common among
athletes, daycare and school aged children, military personal in barracks or others in close living
conditions, and people who have received inpatient medical care.
Symptoms of MRSA includes infection sites that are red, swollen, painful, warm, full of
puss and drainage, and often accompanied by a fever. The pathogen is spread often by improper
care of wounds, in this case the patient might have refrained from bandage changing protocols
and site cleanliness. Potentially the initial issue could have stemmed from scab picking, opening

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of healing sites, or any number of breaking of surfaces. Another concern is that while a medical
professional draining the sites the patient may have attempted to do a similar procedure on their
own. Detection of MRSA is often done by broth microdilution testing (CLSI), disk screen test,
and latex agglutination testing for PBP2. While detection may be difficult at times in most cases
it is not.
Treatment of MRSA drainage is the primary therapy for purulent skin infections. Clinical
assessment can warrant antimicrobial coverage in the presence of systemic symptoms, severe
local symptoms, immune suppression, age, and difficulty in drainage or lack of response to
incision and drainage. This seems to follow suit with the response of medical professionals to
bilateral discharge sinuses. In difficult cases antibiotic treatment is utilized by the profile of the
organism cultured. MRSA also requires a strong follow up program as more serious infection
and complication is possible if neglected.

Resources
(2013). Retrieved February 06, 2016, from http://www.cdc.gov/mrsa/community/index.html
Education & Research Foundation. (n.d.). Retrieved February 06, 2016, from
http://www.idsociety.org/Index.aspx
Neighborhood. (n.d.). Retrieved February 06, 2016, from http://www.nhci.org/

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