What is the diagnosis for Gram-positive cocci in clusters, also known as Staphylococcus (Staph)?

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Last updated: May 22, 2025View editorial policy

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Differential Diagnosis for Gram Positive Cocci in Cluster

  • Single most likely diagnosis
    • Staphylococcus aureus: This is the most common cause of gram-positive cocci in clusters, often associated with skin and soft tissue infections, as well as more severe conditions like bacteremia and endocarditis.
  • Other Likely diagnoses
    • Staphylococcus epidermidis: A common skin commensal that can cause infections, particularly in immunocompromised patients or those with indwelling medical devices.
    • Staphylococcus saprophyticus: Often associated with urinary tract infections, especially in young, sexually active women.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • MRSA (Methicillin-resistant Staphylococcus aureus): A resistant strain of Staphylococcus aureus that can cause severe infections and has significant implications for treatment.
    • Vancomycin-resistant Staphylococcus aureus: Although rare, this strain is highly resistant to common antibiotics and would require specialized treatment.
  • Rare diagnoses
    • Micrococcus: While less common, Micrococcus species can appear as gram-positive cocci in clusters and may be associated with infections in immunocompromised patients.
    • Stomatococcus mucilaginosus: Now known as Rothia mucilaginosa, this bacterium can appear as gram-positive cocci and is associated with infections in patients with compromised immune systems or those with medical devices.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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