TABLE 1.

Culture results and treatment time course of our patient^a

Day(s)	Culture	Treatment	Additional note(s)
1, 3	Blood cultures grew MSSA	i.v. nafcillin for 4 wk	Presenting complaint was fever and cellulitis; the source of the bacteremia was left toe cellulitis
5	Blood cultures showed no growth		By TTE, the EF was 25%; there were no vegetations; a nuclear scan of left foot revealed no osteomyelitis
36	Blood cultures grew MSSA (isolate 1)	p.o. linezolid for 2 wk followed by p.o. cephalexin for 5 days (prescribed for 2 wk but self-discontinued by patient)	Presenting complaint was fever; by TEE, the EF was 25%; there were no vegetations
39	Blood cultures exhibited no growth
62, 63	Blood cultures grew MSSA (isolate 2)	i.v. vancomycin plus i.v. piperacillin-tazobactam for 2 days, followed by i.v. cefazolin for 5 days	Presenting complaint was fever; by TEE, the EF was 55%; there was right atrial vegetation on 2 pacer wires and possibly on the wire extending to the right ventricle
70	Blood cultures exhibited no growth	i.v. vancomycin for 45 days
72	PM/AICD lead culture grew MRSA; the right generator pocket culture grew MRSA (isolate 3)		All AICD/PM leads and the generator were extracted; a temporary AICD/PM was implanted; on day 85, a permanent PM/AICD was reimplanted; at the 6-wk follow-up, the patient was clinically well and afebrile and exhibited no recurrence of bacteremia; at the 4-mo follow-up, the patient was clinically well and afebrile, and there was no recurrence of bacteremia

^ai.v., intravenous; TTE, transthoracic echocardiogram; TEE, transesophageal echocardiogram; EF, ejection fraction; p.o., per os.