Methicillin-Sensitive Staphylococcus aureus (MSSA) Bacteremia With Concomitant Prostatic and Panspinal Epidural Abscesses and Cerebral Infarcts: A Rare Presentation

Methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia is a severe bloodstream infection with potential for metastatic spread to multiple organs. Although prostatic abscesses are typically associated with gram-negative organisms, MSSA may rarely cause disseminated multisystem infection, particularly in patients with significant comorbidities. Early recognition and aggressive intervention are essential to improve outcomes. A 64-year-old man with diabetes, hypertension, and peripheral arterial disease presented with back pain and new-onset atrial fibrillation. Blood cultures confirmed MSSA bacteremia. Imaging revealed a prostatic abscess, extensive panspinal epidural abscess with discitis, and multiple septic cerebral infarcts. After unsuccessful percutaneous drainage, emergent neurosurgical decompression was performed. Antimicrobial therapy was tailored to optimize CNS penetration and address high bacterial burden. The hospital course was complicated by renal failure requiring hemodialysis, nosocomial infections, and extensive venous thromboses. This case underscores the aggressive nature of disseminated MSSA bacteremia and the importance of multidisciplinary management.