A 49-year-old male was admitted for symptoms of an upper respiratory tract infection with a nonhealing diabetic foot wound secondary to longstanding DM with diabetic neuropathy and HTN. Blood cultures revealed MSSA on day 1, and ceftriaxone 2 g every 24 h was initiated on day 2 with clearance observed on day 3. X-rays suggested osteomyelitis, and a below the knee amputation was performed on day 5. Postamputation, ceftriaxone 2 g every 24 h was continued for 4 weeks. The patient was readmitted twice the following month, once for a fall that caused bleeding at the site of the amputation and once for debridement, but cultures did not reveal any MSSA, and no MSSA BSI-related recurrence was noted on either admission.
A 41-year-old male with PMH of uncontrolled DM was admitted for cellulitis of the left lower leg. He continued to worsen despite 5 days of outpatient therapy with clindamycin. Foot ulcer and blood cultures from hospital day 1 grew MSSA; MRI was not indicative of osteomyelitis or septic arthritis. Clindamycin was discontinued, and oxacillin 2 g every 4 h was initiated on day 5. On day 7, oxacillin was changed to ceftriaxone 2 g every 24 h for 4 weeks of outpatient therapy.