Life-threatening infection with multiresistant Staphylococcus epidermidis in a patient with end-stage renal disease: cure with chloramphenicol and quinupristin/dalfopristin (RP 59500).
A 45-year-old man with end-stage renal disease underwent a cadaveric kidney transplantation. The allograft had to he removed 10 days after transplantation because of an acute vascular rejection. After explantation, the patient suffered from a life-threatening infection with Staphylococcus epidermidis involving lungs, eyes and liver for 11 months. Despite adequate therapy including vancomycin followed by teicoplanin, he developed spondylodiscitis requiring repeated surgical interventions. The definitive cure was achieved by a sequential therapy with chloramphenicol and quinupristin/dalfopristin.
Mündlein
E
E
Medizinische Universitätsklinik, Heidelberg, Germany.
von Baum
H
H
Geiss
H K
HK
Springsklee
M
M
Zeier
M
M
Andrassy
K
K
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D002701:Chloramphenicol / Q000627:therapeutic use*; D018432:Drug Resistance, Multiple; D005500:Follow-Up Studies; D006084:Graft Rejection; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D013212:Staphylococcus epidermidis / Q000187:drug effects* / Q000302:isolation & purification; D014769:Virginiamycin / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D014769:Virginiamycin; C062940:quinupristin-dalfopristin; D002701:Chloramphenicol