A 64-year-old female admitted for shortness of breath, weakness, and fatigue with a PMH of HTN, DM, heart failure, atrial fibrillation, and end-stage renal disease (ESRD) had positive MSSA blood cultures from admission. A definitive source for the MSSA BSI was not determined but assumed to be foreign body material (tunneled dialysis catheter, Foley catheter, and implantable cardiac device). She was initiated on ceftriaxone 2 g every 24 h on day 3 and cultures cleared on day 8. She received 4 weeks of ceftriaxone (25 days inpatient and 3 days outpatient).
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.