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.
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).