A Case of Septic Arthritis Caused by Persistent MRSA Bacteremia with Successful Treatment Through Linezolid

Sun Bean Kim; Dong Hyun Oh; Yong Chan Kim; Min Hyung Kim; Je Eun Song; Jin Young Ahn; Su Jin Jeong; Nam Su Goo; Hye Won Kim; Sang Hoon Han; Jun Yong Choi; Young Goo Song; June Myung Kim

doi:10.3947/ic.2012.44.5.403

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Kim, Oh, Kim, Kim, Song, Ahn, Jeong, Goo, Kim, Han, Choi, Song, and Kim: A Case of Septic Arthritis Caused by Persistent MRSA Bacteremia with Successful Treatment Through Linezolid

Case Report

Infection & Chemotherapy

Infection & Chemotherapy 2012; 44(5): 403-406.

Published online: 31 October 2012

DOI: https://doi.org/10.3947/ic.2012.44.5.403

A Case of Septic Arthritis Caused by Persistent MRSA Bacteremia with Successful Treatment Through Linezolid

Sun Bean Kim^1,², Dong Hyun Oh¹, Yong Chan Kim¹, Min Hyung Kim¹, Je Eun Song¹, Jin Young Ahn¹, Su Jin Jeong^1,², Nam Su Goo^1,², Hye Won Kim^1,², Sang Hoon Han^1,², Jun Yong Choi^1,², Young Goo Song^1,², June Myung Kim^1,²

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

²AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.

Correspondence to Sang Hoon Han, M.D. Department of Internal medicine and AIDS Research Institute, Yonsei University College of medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel: +82-2-2228-1991, Fax: +82-2-393-6884, shhan74@yuhs.ac

Received 23 April 2012 Revised 12 June 2012 Accepted 14 June 2012

(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 is the primary antibiotic administered for treatment of methicillin-resistant S. aureus (MRSA) infection; however, treatment failure of vancomycin is currently not uncommon in patients with in vitro vancomycin susceptibile S. aureus (MIC ≤ 2 µg/mL) infection. In this report, we describe a case of septic arthritis caused by persistent MRSA bacteremia and treated successfully with linezolid after failure of initial vancomycin therapy.

Keywords: Methicillin-Resistant Staphylococcus aureus, Bacteremia, Infectious arthritis, Vancomycin, Linezolid

Figures and Tables

Figure 1

Whole body bone scan after intravenous injection of Tc-99m HDP. Increased uptake in the left knee is suggestive of arthritis. Right ilium, superior and inferior pubic rami also show increased uptake, which is compatible with known multiple pelvic bone fracture.

Figure 2

Contrast-enhanced, fat-suppressed T1 weighted magnetic resonance imaging (MRI) of the left knee. (A) MRI shows synovial enhancement, joint effusion, and diffuse soft-tissue edema suggestive of septic arthritis. (B) Synovial enhancement, effusion, and edema showed significant improvement after 32 days of treatment with linezolid.

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