Infect Chemother.  2010 Dec;42(6):415-419. 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

• Lee K
• Kim H
• Kim J
• Lee G
• Lee H
• Kim H
• Kim D
• Sohn I
• Pai H

• KMID: 2170323
• DOI: http://doi.org/10.3947/ic.2010.42.6.415

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.

Keyword

Linezolid; Methicillin-Resistant Staphylococcus aureus; Endocarditis; Bacterial

MeSH Terms

Acetamides
Adult
Amputation
Arteriovenous Malformations
Bacteremia
Endocarditis
Extremities
Humans
Leg
Linezolid
Male
Methicillin Resistance
Methicillin-Resistant Staphylococcus aureus
Mitral Valve
Oxazolidinones
Thigh
Treatment Failure
Vancomycin
Acetamides
Oxazolidinones
Vancomycin

Figure

• 

  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.

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