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 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.