Signs and Symptoms

Dear Mrs. MRSA, 

I am a new nurse and will be starting work at a hospital soon.  I am wondering how I can recognize if my patient has a MRSA infection, and how to recognize when it becomes more serious?

Sincerely, Nursing in Nashville 

Dear Nursing, 

Signs and symptoms of MRSA depend on the location of the infection.  Below I have listed some common sites to watch out for.  

Skin Infection:

MRSA and Skin Infection 

Image Source:
http://www.childrenscolorado.org/wellness-safety/health-library/for-parents/bacterial-viral-infections/mrsa

• Painful, red bump on the skin - looks like an insect bit that develops into a pus filled boil, like a big pimple  

• Sometimes a person will also have a fever.  If you have a fever along with the boil seek medical attention right away.  This could be a sign that the infection has spread to another part of the body.  

• Inflammation of hair follicles - crusty pus filled wounds, sometimes there will not be any pus coming out of the wound but you can feel it deep under the skin - this is called an abscess.  Do not try to bring the pus to the surface.  

• Cellulitis - a deep infection, more serious, underneath the skin, large area of the skin that can get larger as the infection grows.  Red, painful.  

• Other signs that the infection has spread are a general feeling of malaise, chills, swelling of certain areas of the body, muscle ache, dizziness and/or confusion.  

Signs and Symptoms of More Serious forms of MRSA

MRSA + White Blood Cell = Sepsis 

Image Source http://www.webmd.com/a-to-z-guides/ss/slideshow-sepsis-101

• Blood infections/ Sepsis - very high fever, increased heart rate and breathing rate, edema, disorientation, coma.  In addition to the symptoms listed above blood pressure will drop very low, very quickly when the patient is going into septic shock.  

• UTI - pain with urination, frequency and urgency, confusion and changes in mental status especially in older adults, pain in the lower belly or back, malaise

• Pneumonia - mostly seen in young, otherwise healthy patients who were initially sick with the flu or another flu-like disease.  It is very deadly, and must be treated aggressively.  Signs of infection to the lungs would include shortness of breath, very high fever, and bruising easily.  

• Osteomyelitis - extremely painful in the area of infection, you may also see swelling at the area of infection, inability to move the affected area, and general feeling of malaise, high fever. 

For more information about the signs and symptoms of MRSA visit Michelle Moore at Staph Infection Resources.  

References

Rubinstein, E., Kollef, M.H., Nathwani, D. (2008). Pneumonia caused by methicillin-resistant staphylococcus aureus.  Oxford Journals, 46, 378-385.  doi: 10.1086/533594/  

Moore, M. (2015).  MRSA urinary tract infection: risk, facts, symptoms and more.  Retrieved from http://www.staph-infection-resources.com/info/mrsa-uti-infection/  

Davis, C.P., Stoppler, M.C. (2015).  What are the signs and symptoms of a MRSA infection?  Retrieved from http://www.medicinenet.com/mrsa_infection/page4.htm#what_are_the_signs_and_symptoms_of_a_mrsa_infection