A 36-year-old female was admitted for diabetic ketoacidosis (DKA), sepsis, right hand cellulitis, and a right patellar fracture. Her PMH included ESRD, DM, and diabetic nephropathy. She was treated for DKA in the intensive care unit, and her dialysis port was removed as a source of infection. Dialysis port cultures and blood cultures revealed MSSA. She was initially treated with vancomycin, which was de-escalated to oxacillin for days 5 through 9. Oxacillin was switched to cefazolin 2 g every 48 h for days 10 through 13, then changed to ceftriaxone 2 g every 24 h on day 14. She was discharged home on day 21 with 4 weeks of outpatient ceftriaxone.
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.