A 24-year-old male with PMH of testicular cancer and recent chemotherapy was admitted from an OSH with fever and given cefepime. On day 2, blood and sputum cultures became positive for MSSA, and cefepime was de-escalated to oxacillin 2 g every 4 h. A chest CT displayed cavitary lesions determined to be caused by MSSA. It was suspected that the MSSA BSI was due to septic emboli from a central line infection, and his chemotherapy port was removed. On day 8, oxacillin was discontinued, and he was initiated on ceftriaxone 2 g every 24 h. He was discharged on day 10 to complete 4 weeks of therapy. Nine days after discharge, he was readmitted with progressive shortness of breath, fever, chills, and night sweats. A pleural fluid culture yielded MSSA, so he received ceftriaxone on days 1–4 and oxacillin on days 4–7. He was discharged on ceftriaxone therapy to complete the 4 weeks.
A 55-year-old male was admitted with severe pain secondary to a fall with a PMH for HTN and advanced alcoholic cirrhosis. Blood cultures on day 1 were positive for MSSA. Oxacillin 2 g every 4 h was given on days 3–12. The patient achieved MC but failed to achieve CC (WBCs did not normalize within 7 days). On discharge (day 12), he was switched from oxacillin to ceftriaxone 2 g every 24 h. The patient died from liver disease complications 7 days after discharge.