A case of mrsa vertebral osteomyelitis not responding to vancomycin but successfully treated with linezolid

Abstract

An 84-year-old woman was admitted due to pyrexia, cough, and a lumbar backache. She was treated with vancomycin (VCM) under the diagnosis of methicillin-resistant staphylococcus aureus (MRSA) pneumonia. Despite the fact that her pneumonia resolved, her inflammatory marker levels remained high. Abdominal CT and spinal MRI demonstrated a first and second lumbar vertebral osteomyelitis, as well as an extradural abscess communicating with an iliopsoas muscle abscess. MRSA vertebral osteomyelitis was definitively diagnosed on examination of fluid obtained from the iliopsoas muscle abscess. Systemic VCM was changed to systemic linezolid (LZD) due to LZD's excellent penetration into osteo-articular tissues. Inflammatory markers gradually decreased during LZD treatment ; LZD was given for 28 days. 8 months after LZD treatment, reactivation of the MRSA vertebral osteomyelitis has not occured ; additional LZD other antibiotic treatment did not need to be given.