A 36-year-old female was admitted for diabetic ketoacidosis (DKA), sepsis, right hand cellulitis, and a right patellar fracture. Her PMH included ESRD, DM, and diabetic nephropathy. She was treated for DKA in the intensive care unit, and her dialysis port was removed as a source of infection. Dialysis port cultures and blood cultures revealed MSSA. She was initially treated with vancomycin, which was de-escalated to oxacillin for days 5 through 9. Oxacillin was switched to cefazolin 2 g every 48 h for days 10 through 13, then changed to ceftriaxone 2 g every 24 h on day 14. She was discharged home on day 21 with 4 weeks of outpatient ceftriaxone.
A 68-year-old female had positive blood cultures for MSSA and a paraspinal abscess, which was subsequently drained, and a TEE displayed a large vegetation on the right atrial junction. She was initially treated with oxacillin 2 g every 4 h from days 5 to 12. Negative blood cultures were obtained on day 9. On discharge (day 13), ceftriaxone 2 g every 24 h was initiated for completion of 6 weeks of therapy from first negative blood culture. Follow-up computed tomography (CT) scans showed that the paraspinal abscess resolved.