Table 2.

Review of acute osteomyelitis cases caused by CA-MRSA in adults

No	Ref	Age/ sex	Underlying disease	Probable source of entry	Symptoms	Manifestation	Culture source	PVL	Treatment	Outcome
1	11*	27/M	None	History of furunculosis Contact with gym facilities	Leg pain and fever	Femur osteomyelitis	Bone	+	Vancomycin −8 weeks Surgical debridement	Recovered and no relapse during follow-up
2	11 *	37/M	Hepatitis C Hypertension	History of furunculosis Contact with children with ‘skin bumps’	Leg pain and fever	Femur osteomyelitis	Bone	+	Vancomycin- 8 weeks Surgical debridement	Recovered and no relapse during follow-up
				IVDU
3	12	45/M	None	NA	Right hemithorax pain and swelling Fever	First rib osteomyelitis, pyomyositis, thoracic wall abscesses, septicaemia	Bone, blood, pus and tissue	+	Clindamycin, tobramycin+ linezolide, vancomycin (given at different times for 6 weeks)	Recovered
									Surgical debridements Abscess drainage
4	13 *	34/M	None	Axillary furuncle	Thigh pain	Femur osteomyelitis, bacteraemia	Bone and blood	NA	Vancomycin +rifampicin	Recovered and no relapse during follow-up
									– 12 weeks
									Surgical debridement Intramedullary rod
5	14 *	46/F	Hypertension	History of furunculosis in patient and daughter	Arm pain	Humerus osteomyelitis with pathological fracture	Bone	NA	Vancomycin+ rifampicin (various combination total of 16 weeks)	Recovered and no relapse during follow-up
									Surgical debridement
									ORIF
6	14	28/F	Hepatitis C	History of furunculosis Subcutaneous heroin injection	Thigh pain and swelling	Femur osteomyelitis, pyomyositis, and bacteraemia	Bone and blood	NA	Vancomycin, linezolide, daptomycin (various combination)	Recovered and no relapse during follow-up
									ORIF
									Surgical debridement
7	15	22/M	None	Elbow cellulitis Works at military base	Knee and thigh pain Fever	Femur osteomyelitis. septic arthritis of knee bacteraemia, thigh abscess, endocarditis, septic lung emboli, deep vein thrombosis	Wound and blood	+	Vancomycin + clindamycin,	Survived with disabilities
									Vancomycin + linezolid (various combination- total of 8 weeks)
									Incision and drainage
8	16	46/M	Hepatitis C with cirrhosis	IVDU	Back pain and fever	Lumbar osteomyelitis, pyomyositis of paraspinal and psoas muscle, spinal epidural abscess, bacteraemia	Blood and pus	NA	Abscess drainage	Recovered and no relapse during follow-up
									Surgical debridement Vancomycin- 6 weeks
9	Present*	28/M	None	Extensive direct contact with deer	Thigh pain and swelling Fever	Femur osteomyelitis, septic arthritis of knee pyomyositis bacteraemia	Bone, blood, pus and tissue	+	Abscess drainage Arthrotomy	Recovered and no relapse during follow-up
	Case
									Surgical debridement Vancomycin+fusidic Fusidic + rifampicin- 6 months
				Consumed deer meet

*Suspected primary bone malignancy.

NA- not available.