Insights From a Case of MRSA Enterocolitis in the Setting of Rectal Cancer

Methicillin-resistant Staphylococcus aureus (MRSA) is a rare cause of infectious enterocolitis. We present a patient undergoing chemoradiation for rectal squamous cell carcinoma who presented with acute watery diarrhea, neutropenia, and radiographic findings consistent with colitis. Failure to improve with empirical antibiotics prompted readmission and repeat stool culture, which resulted with heavy growth MRSA responsive to oral vancomycin. Low clinical suspicion for MRSA as the causing agent led to a delay in appropriate antibiotics and prolonged hospitalization, which ultimately resulted in death. In patients who are immunocompromised with active malignancy and undifferentiated infectious enterocolitis, early MRSA screening and empirical coverage should be considered.