J Korean Neurosurg Soc.  2008 Jun;43(6):307-310. 10.3340/jkns.2008.43.6.307.

Linezolid Treatment for Osteomyelitis due to Staphylococcus Epidermidis with Reduced Vancomycin Susceptibility

• Nam JR
• Kim MS
• Lee CH
• Whang DH

• KMID: 2189395
• DOI: http://doi.org/10.3340/jkns.2008.43.6.307

Abstract

Limited therapeutic options are available for vancomycin intermediate-resistant Staphylococcus Epidermidis (VISE) infections and no optimum therapy has been established. We report a case of VISE skull osteomyelitis that was successfully treated with linezolid. The patient was a 53-year-old man who presented with headache, nausea and dysphasia. Brain computerized tomography (CT) demonstrated a subdural hematoma in the left hemisphere. Craniotomy and hematoma evacuation was performed and he showed good recovery despite a scalp wound infection caused by methicillin-resistant Staphylococcus aureus (MRSA). The organism isolated from the scalp wound was sensitive to vancomycin. The patient was treated with intravenous vancomycin for 44 days. However, he showed a high fever, persistent positive methicillin-resistant Staphylococcus Epidermidis (MRSE) blood cultures, and a deteriorating clinical status. He underwent infected skull bone flap removal and linezolid treatment for 35 days. During one year of follow up, he has not had any further episodes of osteomyelitis or fever. Linezolid has shown to be effective agent to eradiate osteomyelitis caused by VISE.

Keyword

Vancomycin-resistance; Staphylococcus Epidermidis; Linezolid; Skull osteomyelitis

MeSH Terms

Acetamides
Aphasia
Brain
Craniotomy
Fever
Follow-Up Studies
Headache
Hematoma
Hematoma, Subdural
Humans
Methicillin Resistance
Methicillin-Resistant Staphylococcus aureus
Middle Aged
Nausea
Osteomyelitis
Oxazolidinones
Scalp
Skull
Staphylococcus
Staphylococcus epidermidis
Vancomycin
Wound Infection
Linezolid
Acetamides
Oxazolidinones
Vancomycin