A 24-year-old male with PMH of testicular cancer and recent chemotherapy was admitted from an OSH with fever and given cefepime. On day 2, blood and sputum cultures became positive for MSSA, and cefepime was de-escalated to oxacillin 2 g every 4 h. A chest CT displayed cavitary lesions determined to be caused by MSSA. It was suspected that the MSSA BSI was due to septic emboli from a central line infection, and his chemotherapy port was removed. On day 8, oxacillin was discontinued, and he was initiated on ceftriaxone 2 g every 24 h. He was discharged on day 10 to complete 4 weeks of therapy. Nine days after discharge, he was readmitted with progressive shortness of breath, fever, chills, and night sweats. A pleural fluid culture yielded MSSA, so he received ceftriaxone on days 1–4 and oxacillin on days 4–7. He was discharged on ceftriaxone therapy to complete the 4 weeks.
A 64-year-old female admitted for shortness of breath, weakness, and fatigue with a PMH of HTN, DM, heart failure, atrial fibrillation, and end-stage renal disease (ESRD) had positive MSSA blood cultures from admission. A definitive source for the MSSA BSI was not determined but assumed to be foreign body material (tunneled dialysis catheter, Foley catheter, and implantable cardiac device). She was initiated on ceftriaxone 2 g every 24 h on day 3 and cultures cleared on day 8. She received 4 weeks of ceftriaxone (25 days inpatient and 3 days outpatient).