n the month of November 2022, A 35-year-old male patient was admitted to the hospital with high grade fever, He claimed to have redness & swelling in his left leg, difficulty breathing, a fever, and irritability. His fever was 38.5 degrees Celsius, and his blood pressure was 140 over 80 mm Hg when he was admitted. The results of the laboratory testing indicated an increased count of white blood cells and increased levels of blood glucose. He was a known case of diabetes.

After further assessment, it was determined that he had an infection in his foot that had developed into complicated cellulitis. In order to identify the causative organism with antibiotic sensitivity pattern, blood culture test was sent. Two routine sets of blood cultures are recommended for the precise diagnosis and appropriate treatment of cellulitis in elderly patients, especially in patients with shaking chills or leukocytosis. He was started empirical i.v. antibiotics. The empirical antibiotic treatment consisted of oral linezolid for cellulitis, intravenous meropenem for gram-negative bacteria cover, and intravenous doxycycline for atypical bacterial cover.

Later on, during the second day of hospitalization, the provisional results of the blood cultures came back positive for methicillin-resistant Staphylococcus aureus (MRSA), which indicated that he was having MRSA bacteremia.

Because of his diabetes, he was considered as a high risk case for the complications those are associated with MRSA bacteremia. He had poor control of his blood glucose levels for years which resulted in the diabetic neuropathy in his feet. In addition to this, there was a possibility that he may develop sepsis, which is a potentially fatal consequence of bacteremia.

The patient’s antibiotics were upgraded as per sensitivity on the culture report. He was given intravenous vancomycin and Levonadifloxacin.