Abstract
Continuous high-grade Staphylococcus aureus bacteremia suggests acute bacterial endocarditis (ABE), a protected focus, ie, an abscess, or a device-related infection. Daptomycin was curative of S. aureus ABE and coronary stent-related bacteremia. Prolonged high-dose daptomycin therapy (12 mg/kg per day for 41 days) is not associated with any toxicity. Persistent S. aureus bacteremia in ABE should suggest myocardial or perivalvular abscess. If intracardiac abscess can be ruled out and there is no extracardiac source of the S. aureus bacteremia, then a device-related infection should be considered.
MeSH terms
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Aged
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Anti-Bacterial Agents / pharmacology
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Anti-Bacterial Agents / therapeutic use
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Bacteremia / diagnosis
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Bacteremia / drug therapy
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Bacteremia / etiology*
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Coronary Disease / complications
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Coronary Disease / therapy
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Daptomycin / pharmacology
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Daptomycin / therapeutic use
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Echocardiography
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Endocarditis, Bacterial / diagnosis
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Endocarditis, Bacterial / drug therapy
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Endocarditis, Bacterial / etiology*
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Heart Valve Diseases / diagnosis
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Heart Valve Diseases / drug therapy
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Heart Valve Diseases / microbiology
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Humans
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Male
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Methicillin Resistance
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Mitral Valve
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Pacemaker, Artificial / adverse effects*
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Prosthesis-Related Infections / complications*
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Prosthesis-Related Infections / diagnosis
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Prosthesis-Related Infections / drug therapy
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Staphylococcal Infections / diagnosis
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Staphylococcal Infections / drug therapy
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Staphylococcal Infections / etiology*
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Stents / adverse effects*
Substances
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Anti-Bacterial Agents
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Daptomycin