Sequestration of staphylococci at an inaccessible focus.
The persistence of staphylococcal arthritis in a patient treated with nafcillin was attributed to intracellular sequestration of staphylococci. These intraphagocytic organisms were protected against bactericidal activity. The infection was cleared by rifampin--an agent which can penetrate leucocyte membranes. When clinical infections do not respond to seemingly adequate antimicrobial treatment, intracellular persistence of bacteria should be considered.
D000328:Adult; D001170:Arthritis, Infectious / Q000188:drug therapy* / Q000276:immunology; D004551:Elbow Joint / Q000382:microbiology*; D006801:Humans; D007719:Knee Joint / Q000382:microbiology*; D008297:Male; D009254:Nafcillin / Q000627:therapeutic use; D010403:Penicillin Resistance; D010587:Phagocytosis; D012293:Rifampin / Q000627:therapeutic use; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000276:immunology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000276:immunology; D013582:Synovial Fluid / Q000382:microbiology*
D009254:Nafcillin; D012293:Rifampin