Table 2.
Microbiology Results and Treatment Regimens
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Culture Results
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Treatment
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Patient | Age | Gender | Aerobic | Fungal | AFB | Antibiotic | No. of Courses/Total Duration |
1 | 55 | M | MSSA | Negative | Negative | TMP-SMX | 1/180 d |
2 | 86 | M | Pseudomonas | Positive | NA | Ciprofloxacin | 1/21 d |
3 | 56 | M | MSSA | Negative | NA | None | Patient lost to follow-up |
4 | 70 | M | MRSA | Negative | Negative | TMP-SMX | 3/215 d |
5 | 40 | M | MSSA | Negative | NA | TMP-SMX | 4/192 d |
6 | 63 | M | MSSA | Negative | NA | TMP-SMX | 2/261 d |
7 | 62 | M | MSSA | Negative | NA | TMP-SMX | 3/171 d |
8 | 46 | F | “Normal respiratory flora” | Negative | Negative | None | No treatment indicated |
9 | 36 | F | Serratia then MSSA | Negative | NA | Levofloxacin, TMP-SMX | 1/14 d (L); 1/28 d (B) |
10 | 66 | M | MSSA | Negative | NA | TMP-SMX | 1/90 d |
11 | 38 | F | MSSA | Negative | Negative | TMP-SMX | 1/10 d |
12 | 46 | M | MSSA | Negative | Negative | TMP-SMX | Multiple at OSH |
13 | 54 | F | Serratia and MSSA | Negative | Negative | None | NA |
14 | 69 | F | MSSA | Negative | Negative | TMP-SMX | 1/56 d |
15 | 38 | M | MSSA | Negative | Negative | Cephalexin | 1/28 d |
Patient No. 3 did not follow up after his biopsy for culture, so treatment was never initiated. Patient No. 9 initially had Serratia and was treated with levofloxacin (L). Repeat culture demonstrated only MSSA, and treatment consisted of TMP-SMX (B). Levofloxacin appeared to be successful in treating Serratia. Patient No. 11 was prescribed a longer course of antibiotics but stopped TMP-SMX early secondary to a rash. Patient No. 12 had multiple courses of TMP-SMX at an outside institution, but the exact duration was not available. The culture from Patient No. 13 grew Serratia and MSSA simultaneously. Patient No. 13 was evaluated by infectious disease, and the decision was made not to treat the culture results. Abbreviations: AFP, acid-fast bacteria; MRSA, Methicillin-resistant Staphylococcus aureus; MSSA, Methicillin-sensitive Staphylococcus aureus; OSH, outside hospital; TMP-SMX, trimethoprim-sulfamethoxazole or Bactrim.