Background: The incidence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection is increasing, and 0.5-4% of pregnant women are colonized.
Case: A 30-year-old pregnant woman at term presented with intractable headache 1 week after incision and drainage of a MRSA-positive axillary abscess. Imaging demonstrated a right-sided epidural abscess with midline shift and myositis of the overlying temporalis muscle. She underwent cesarean delivery followed by craniectomy of osteomyelitic bone and evacuation of the epidural abscess.
Conclusion: Central nervous system abscess is rare but should be considered in patients with a history of MRSA infection and new neurologic signs or symptoms. Surgical evacuation and antibiotic therapy in combination with obstetrical care considering delivery timing based upon maternal stability and gestational age may produce excellent outcomes.
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