Fatal Brain Abscess due to Community-Associated Methicillin-Resistant Staphylococcus aureus Strain USA300

We report a fatal case of brain abscess caused by infection due to a community-associated methicillin-resistant Staphylococcus aureus strain (USA300) in a 37-year-old incarcerated woman with a history of furunculosis and injection drug use.Community-onset pyogenic brain abscess should be added to the growing list of life-threatening invasive infections caused by epidemic community-acquired methicillinresistant S. aureus.During the past 6 years, outbreaks of skin and soft-tissue infections due to a new and, perhaps, more virulent strain of community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA) have been reported among certain groups of individuals, including athletes, prisoners, men who have sex with men, and military recruits [1][2][3][4][5].Like other CA-MRSA strains, this strain, called USA300 according to the nomenclature of the Centers for Disease Control and Prevention, harbors a staphylococcal cassette chromosome mec (SCCmec) element that is distinct from those found in health care-associated MRSA strains and typically carries the Panton-Valentine leukocidin toxin genes [5,6].Furthermore, genome sequencing has revealed that USA300 contains a novel 31-kb genetic island, termed the arginine catabolic mobile element (ACME), which has been postulated to enhance the colonization and/or virulence fitness of the strain [7].Indeed, a recent study reported that CA-MRSA was the most commonly identified cause of