A 57-year-old male was admitted for sepsis secondary to septic arthritis of the right hip and left shoulder. He had a PMH of rheumatoid arthritis and was receiving long-term immunosuppressive therapy with prednisone. Blood cultures on admission were positive for MSSA. On day 3, the left shoulder was irrigated and debrided. Ceftriaxone 2 g every 24 h was initiated on day 6 for 6 weeks of therapy from first negative blood culture. An MRI revealed erosive changes along both sides of the right hip joint, and an antibiotic spacer was placed on hospital day 7.
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.