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Case Reports
. 2011 May 26:11:152.
doi: 10.1186/1471-2334-11-152.

High-dose daptomycin and fosfomycin treatment of a patient with endocarditis caused by daptomycin-nonsusceptible Staphylococcus aureus: case report

Liang-Yu Chen  1 , Cheng-Hsiung Huang, Shu-Chen Kuo, Chen-Yuan Hsiao, Mei-Lin Lin, Fu-Der Wang, Chang-Phone Fung
Affiliations
Case Reports

High-dose daptomycin and fosfomycin treatment of a patient with endocarditis caused by daptomycin-nonsusceptible Staphylococcus aureus: case report

Liang-Yu Chen et al. BMC Infect Dis. .

Abstract

Background: Emergence of daptomycin-nonsusceptible (DNS) Staphylococcus aureus is a dreadful problem in the treatment of endocarditis. Few current therapeutic agents are effective for treating infections caused by DNS S. aureus.

Case presentation: We describe the emergence of DNS S. aureus. in a patient with implantable cardioverter-defibrillator (ICD) device -related endocarditis who was priorily treated with daptomycin. Metastatic dissemination as osteomyelitis further complicated the management of endocarditis. The dilemma was successfully managed by surgical removal of the ICD device and combination antimicrobial therapy with high-dose daptomycin and fosfomycin.

Conclusions: Surgical removal of intracardiac devices remains an important adjunctive measure in the treatment of endocarditis. Our case suggests that combination therapy is more favorable than single-agent therapy for infections caused by DNS S. aureus.

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