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 35-year-old female was admitted for fever with swelling and pain at the site of the peripherally inserted central catheter (PICC) in her left arm. She had a PMH of gastroparesis with multiple abdominal surgeries and was reliant on total parenteral nutrition. Blood cultures revealed MSSA, and her PICC was removed for 48 h before a new one was placed. She received ceftriaxone 1 g every 24 h on days 1–3. Ceftriaxone was switched to oxacillin 2 g every 6 h on day 4. She was changed back to ceftriaxone 2 g every 24 h on day 12, then discharged to a long-term acute care (LTAC) facility on day 23. She continued ceftriaxone at LTAC for 8 additional days.