title: [A case of MRSA infection in multiple artificial joints successfully treated with conservative medical treatment].
abstract: We report herein on a case with multiple MRSA prosthetic arthritis and osteomyelitis successfully treated medically. Our patient was a 64-year-old Japanese woman with a previous medical history of malignant rheumatoid arthritis and multiple surgical interventions with an atlantoaxial fixation in 2003, artificial joint replacement of both knee joints in 2006, and of the right hip joint in September, 2007. She was initially hospitalized due to MRSA arthritis in the right hip in October, 2007. Thereafter, multiple joint infections occurred sequentially in the right knee joint in January 2008 and the left hip joint in June 2008. More recently, the patient was re-admitted in January 2009 due to cervical osteomyelitis with MRSA infection. The patient had been treated with a combination of vancomycin and rifampin for 17 weeks and followed by sulfamethoxazole/trimetoprim in the out-patient setting up to the present. Although the complete resolution of multiple deep MRSA infections with prosthetic arthritis and osteomyelitis is not expected without removing the infectious sources, our patient was successfully treated with chronic antibiotic suppressive therapy. Therefore, we report on our case with a literature review.
authors.affiliation: Division of General Internal Medicine, Ut St. Marianna University School of Medicine Hospital.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Nemoto
authors.forename: Yukitaka
authors.initials: Y
authors.lastname: Yamasaki
authors.forename: Keito
authors.initials: K
authors.lastname: Torikai
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishii
authors.forename: Shigeki
authors.initials: S
authors.lastname: Fujitani
authors.forename: Takahide
authors.initials: T
authors.lastname: Matsuda
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001170:Arthritis, Infectious / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000276:immunology*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D012293:Rifampin / Q000627:therapeutic use; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D012293:Rifampin