Successful Treatment of Recurrent Methicillin-resistant Staphylococcus aureus Bacteremia and Endocarditis by Linezolid, Valve Replacement, and Excisional Surgery of Limb in a Patient with Complicated Arteriovenous Malformation

Kangwon Lee; Hyuck Kim; Jieun Kim; Gilwoo Lee; Hyungtak Lee; Hyungtae Kim; Dongchan Kim; Ilwoong Sohn; Hyunjoo Pai

doi:10.3947/ic.2010.42.6.415

Journal List > Infect Chemother > v.42(6) > 1035049

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Lee, Kim, Kim, Lee, Lee, Kim, Kim, Sohn, and Pai: Successful Treatment of Recurrent Methicillin-resistant Staphylococcus aureus Bacteremia and Endocarditis by Linezolid, Valve Replacement, and Excisional Surgery of Limb in a Patient with Complicated Arteriovenous Malformation

Case Report

Infection & Chemotherapy

Infection & Chemotherapy 2010; 42(6): 415-419.

Published online: 31 December 2010

DOI: https://doi.org/10.3947/ic.2010.42.6.415

Successful Treatment of Recurrent Methicillin-resistant Staphylococcus aureus Bacteremia and Endocarditis by Linezolid, Valve Replacement, and Excisional Surgery of Limb in a Patient with Complicated Arteriovenous Malformation

Kangwon Lee¹, Hyuck Kim², Jieun Kim¹, Gilwoo Lee¹, Hyungtak Lee¹, Hyungtae Kim¹, Dongchan Kim¹, Ilwoong Sohn¹, Hyunjoo Pai¹

¹Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

²Department of Thoracic and Cardiovascular surgery, Hanyang University College of Medicine, Seoul, Korea.

Correspondence to Hyunjoo Pai, M.D. Department of Infectious disease, Hanyang University Medical Center, 17 Haengdang-dong, Sungdong-gu, Seoul 133-070, Korea. Tel: +82-2-2290-8356, Fax: +82-2-2298-9183, paihj@hanyang.ac.kr

Received 28 June 2010 Revised 1 September 2010 Accepted 1 September 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Vancomycin treatment failure in methicillin-resistant Staphylococcus aureus (MRSA) bacteremia patients has increased over the past decade. We experienced a case of repeated MRSA bacteremia resulting in left-side endocarditis in 38-year-old male with a huge complicated arteriovenous malformation in the left thigh. After vancomycin treatment failure, the patient was successfully treated with the administration of linezolid, leg amputation, and mitral valve replacement.

Keywords: Linezolid, Methicillin-Resistant Staphylococcus aureus, Endocarditis, Bacterial

Figures and Tables

Figure 1

Parasternal long-axis view of transthoracic echocardiography. 2.7×1.4 cm sized vegetation is noted on the anterior mitral valve leaflet.

Figure 2

Transesophageal echocardiography of the left heart. (A) A frail vegetation of about 3.1 cm in size can be noted on the anterior mitral valve and another vegetation measuring about 0.5 cm can be seen on the posterior mitral valve leaflet. (B) Transesophageal color Doppler echocardiography demonstrates the presence of severe mitral regurgitation.

Figure 3

CT angiography of the lower extremity. Huge arteriovenous malformation is noted on the left thigh.

Table 1

MIC and Antibiogram of Isolated Staphylococcus aureus

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