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Stroke in Henoch-Schönlein Purpura Associated with Methicillin-Resistant Staphylococcus aureus Septicemia: Report of a Case and Review of the Literature

Kanya Temkiatvises MD*, Yongchai Nilanont MD*, Niphon Poungvarin MD, FRCP*

Affiliation : * Division of Neurology, Department of Medicine,Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok

Neurological involvement in Henoch-Schönlein purpura (HSP) such as stroke is uncommon manifestiation, particularly in association with Staphylococcus aureus (S. aureus). The authors reported a 17-year-old man who developed sudden onset of right hemiparesis while he was admitted in the hospital about his prolonged fever, palpable purpura and upper gastrointestinal bleeding. He also had evidence of MRSA septicemia before the onset of right hemiparesis. Skin biopsy was done and showed that there was leukocytoclastic vasculitis with IgA deposition. He had received completed course of antibiotics and then he was subsequently improved after steroid therapy in the next 2 weeks. Review of case reports from previous English literatures, discovered the association between MRSA infection and HSP which can cause several CNS manifestations including stroke symptoms from cerebral vasculitis.

Keywords : Stroke, Henoch-Schönlein purpura, Cerebral vasculitis, MRSA septicemia


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