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 19-year-old male admitted for possible meningitis presented with numbness and fever and developed acute paraplegia secondary to a spinal abscess. Surgical and blood cultures revealed MSSA on day 1, then the patient developed sepsis secondary to a pulmonary septic embolus. Vancomycin was discontinued, and oxacillin 2 g every 4 h was initiated on day 4. He had negative blood cultures on day 6. On day 14, he was discharged to rehabilitation on ceftriaxone 2 g every 24 h for 8 weeks.