Table 2 Review of acute osteomyelitis cases caused by CA-MRSA in adults

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