When the Skin Speaks: Methicillin-resistant Staphylococcus aureus Suprapubic Abscess in a Renal Transplant Recipient.
Sahibjeet Singh, Charan Bale, Vivek Biradar
✦ AI-curated · Sources linked
Case in brief
A 33-year-old renal transplant recipient receiving tacrolimus, mycophenolate sodium, and steroids presented with low-grade fever and a painful, progressive suprapubic lesion with discharge, without urinary or other localizing symptoms. Although dermatological assessment raised possible herpes zoster, surgical exploration found a localized abscess, and pus culture grew methicillin-resistant Staphylococcus aureus (MRSA). Mycophenolate was withheld, and treatment was escalated to daptomycin, followed by clinical improvement and healthy granulation tissue. Despite resolution of the infection, graft dysfunction persisted, with serum creatinine 4.8 mg/dL at discharge.
What made this case unusual
The lesion initially suggested herpes zoster, but exploration revealed an MRSA abscess; the infection improved while graft dysfunction persisted.
Diagnostic / clinical pearl
In a renal transplant recipient, a painful cutaneous lesion may be an abscess even when its appearance suggests another diagnosis; surgical exploration and culture can establish the cause and guide targeted therapy.