Severely swollen upper lip associated with methicillin-resistant Staphylococcus aureus infection

Acute lip swelling can arise from infections, reactive responses, cystic lesions, neoplasms, or systemic diseases. 1Delayed or ineffective treatment of the lip could lead to long-term aesthetic and functional complications.Methicillin-resistant Staphylococcus aureus (MRSA) can cause various skin and soft tissue infection; however, severe lip involvement is exceedingly rare.Knowledge related to its treatment and prognosis is very limited.Therefore, we would like to present a unique case of MRSA-related lip cellulitis and its management.A 73-year-old male with a medical history of anemia presented to our emergency department with significant upper lip swelling that had progressively worsened over 5 days.He was afebrile and slightly hypertensive, but he felt well overall despite the swelling.Physical examination revealed erythematous swelling with dark scabs, deep ulceration, and suppurative fistulas (Fig. 1AeC).Laboratory tests showed elevated C-reactive protein (16.23 mg/dL) and serum creatine (2.49 mg/dL).The patient denied any allergies, recent medications, trauma, insect bite, or travel history.The preliminary diagnosis was non-odontogenic lip cellulitis with impaired renal function.Under local