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Journal of Korean Neurosurgical Society 2008;43(6): 307-310.
doi: https://doi.org/10.3340/jkns.2008.43.6.307
Linezolid Treatment for Osteomyelitis due to Staphylococcus Epidermidis with Reduced Vancomycin Susceptibility.
Joon Rok Nam, Myoung Soo Kim, Chae Heuck Lee, Dong Hee Whang
1Department of Neurosurgery, Seoul Paik Hospital, Inje University, College of Medicine, Seoul, Korea. hanibalkms@hanmail.net
2Department of Laboratory Medicine, Seoul Paik Hospital, Inje University, College of Medicine, Seoul, Korea.
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.
Key Words: Vancomycin-resistance; Staphylococcus Epidermidis; Linezolid; Skull osteomyelitis
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