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Persistent bacteremia in staphylococcal endocarditis

M T Reymann, H P Holley, C G Cobbs

    The American Journal of Medicine
    |November 1, 1978
    PubMed
    Summary
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    Persistent Staphylococcus aureus bacteremia and endocarditis require surgical intervention or specific antibiotics for cure. This study explores treatment approaches for challenging cases of Staphylococcus aureus infection.

    Area of Science:

    • Infectious Diseases
    • Cardiology
    • Microbiology

    Background:

    • Staphylococcus aureus bacteremia and endocarditis pose significant clinical challenges.
    • Persistent infections often necessitate aggressive therapeutic strategies.

    Observation:

    • Five patients with persistent Staphylococcus aureus bacteremia and endocarditis were treated.
    • Surgical intervention or second-line antistaphylococcal agents were crucial for bacteriologic cure.
    • Standard testing did not reveal methicillin resistance or antibiotic tolerance in the tested strains.

    Findings:

    • Cephalosporins exhibited greater susceptibility to inoculum effect compared to methicillin or nafcillin.
    • All patients in the study survived their infections.
    • The reasons for the patients' atypical clinical course remain unclear.

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    Implications:

    • This study highlights the complexity of treating persistent Staphylococcus aureus infections.
    • It suggests an approach for managing challenging cases of Staphylococcus aureus bacteremia and endocarditis.
    • Further research is needed to elucidate the mechanisms behind atypical treatment responses.