Spiders Or Staphs? A Misdiagnosis Can Be Deadly

Illinois personal injury lawyer T. Evan Schaeffer posts about a rews article that reminds us doctors need to be current in their diagnositic skills. Serious staph infections erroneously called spider bites are not being treated promptly enough.

Illinois personal injury lawyer T. Evan Schaeffer posts about a news article that reminds us doctors need to be current in their diagnositic skills. Serious staph infections erroneously called spider bites are not being treated promptly enough.

From the St. Louis Post-Dispatch: “Staph cases spread,” by Deborah Shelton–

Cases of a virulent form of staph infection are not only skyrocketing in the St. Louis region and elsewhere, but some local doctors are allowing its spread by misdiagnosing the bacterial infection as spider bites.

The superbug is called methicillin-resistant staphylococcus aureus, or MRSA. It can be dangerous because it doesn’t respond to some of the standard antibiotic treatments.

Schaeffer and the Illinois personal injury firm of Schaeffer & Lamere, P.C., continue to provide topical news and viewpoints in the field of personal injury law.

The British Medical Journal, coincidentally, publishes its article informing the medical profession that community admissions make up one-fourth of hospital MRSA bacteremia cases.

A summary from MD Consult, an excellent source of medical information:

October 31, 2005

ST LOUIS (MD Consult) – One-fourth of inpatients with positive methicillin-resistant Staphylococcus aureus (MRSA) blood cultures on admission are admitted from the community, with nearly all having a history of previous hospital care, according to a study in the Oct. 29 British Medical Journal.

Dr David H. Wylie and colleagues of John Radcliffe Hospital, Oxford, performed a record linkage study to assess rates and risk factors for MRSA in patients admitted to two Oxfordshire acute-care hospitals. Blood cultures obtained during the first two days after admission were analyzed for MRSA, as well as for methicillin-sensitive S. aureus (MSSA). The study, using data from hospital information and microbiology data bases, comprised all patients admitted to a teaching hospital from 1997 to 2003 and to a district general hospital from 1999 to 2003.

Analysis of patients admitted to the teaching hospital from the community identified 479 patients with positive cultures for MSSA and 116 with MRSA bacteremia. The latter group accounted for 24% of all hospital MRSA cases. Thirty-one percent of these patients had previously received intensive day-case treatment at hospital renal, oncology, or hematology services. Of the remaining 61%, most were admitted as medical or surgical emergencies. This group consisted mainly of elderly patients with extensive previous health care contacts and evidence of risk factors for diabetes, ulcers, and urinary catheterization.

Overall, 91% of patients with MRSA had a history of previous hospitalization—median time since discharge was 46 days. Approximately half had no previous history of MRSA isolation. Similar patterns were found on analysis of the general hospital data.

In the United Kingdom as in the United Sates, most strains of MRSA are hospital based. The U.K. national surveillance system for MRSA bacteremia has yet to determine whether MRSA is being imported into hospitals from the community.

The new results suggest that patients admitted from the community make up approximately one-fourth of cases of hospital MRSA bacteremia identified over a 7-year period. The number of such cases has increased in recent years. Nearly all of these patients have a history of previous hospitalization, and about half have not previously been identified as having MRSA. The findings have important implications for diagnostic strategies and policies concerning antibiotics use, the authors conclude.

BMJ. 2005;331:992.