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

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

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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 torpedo 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 Wide Leg 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.