A common pathogen in an uncommon site: coronary artery stent meticillin-resistant Staphylococcus aureus infection.

Abstract

Introduction. Coronary artery stents are an uncommon site for infection. Only a handful of case reports describe this condition, and Staphylococcus aureus is the most frequent pathogen. Although rare, coronary stent infections are associated with a high mortality rate. Case presentation. We describe the case of a 50-year-old man with a past medical history of seven prior meticillin-resistant S. aureus (MRSA) infections over the previous 12 months, who presented with fever and was found to have persistent MRSA bacteraemia. During his hospital course, he developed chest pain and underwent coronary angiography, which revealed a left circumflex coronary to left atrium fistula, presumably due to endarteritis/sent infection. He was treated with combination parenteral antibiotics that were succeeded by oral suppressive therapy. Six months after his diagnosis of coronary stent infection, he suffered a fatal cardiac arrest. Conclusion. Coronary artery stents are an infrequent source of infection; when they occur, they are typically due to S. aureus, have a high mortality and ideally are treated with surgical intervention.