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Osteomyelitis - A case report
Australian Family Physician, 07/28/09

Puthiyaveetil SA – This article presents a case of community acquired MRSA infection resulting in severe osteomyelitis of the humerus, followed by a brief discussion and literature review.

• Community acquired MRSA infections are becoming increasingly prevalent.
• CAMRSA commonly causes minor skin and soft tissue infections. Occasionally, it can be responsible for significant morbidity and mortality.
• Nasal colonisation has not been found consistently to precede the infection with CAMRSA.
• Clinicians should have a low threshold for obtaining specimens for culture in the setting of skin and soft tissue infections particularly when the patient does not respond rapidly to drainage and standard antimicrobial therapy.
• The majority of CAMRSA are susceptible to tetracyclines, cotrimaxozole, rifampicin, fusidic acid and vancomycin.
• Strains vary in their resistance to erythromycin. Erythromycin resistant isolates may respond to clindamycin, but there is a concern that these clones can mutate to a erythromycin/clindamycin resistant strain.
• In the presence of more serious and invasive infections, immediate therapy with vancomycin or linezolid should be instituted without delay until treatment can be modified by culture results.

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