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 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.