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 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.