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The diagnosis is established by isolation of S aureus from the blood, bone, or a contiguous focus of a patient with signs and symptoms of focal bone infection Blood culture will be positive in approximately 60% of untreated cases Bone biopsy and culture are indicated if blood cultures are sterile
Bone scan and gallium scan, each with a sensitivity of approximately 95% and a specificity of 60 70%, are useful in identi-
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Sep 22, 2018 · This video is how to upload pdf file and save path to databse and display that pdf in asp.net c ...Duration: 12:15
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patients for whom the pretest probability of endocarditis is 5% or higher and for all patients with unexplained S aureus bacteremia Vancomycin treatment failures are relatively common, particularly for complicated bacteremia, in foreign body infection, or when the MIC of the isolate is > 2 mcg/mL Maintaining trough concentrations of 15 20 mcg/mL may improve outcome Consultation should be sought with an infectious diseases specialist when vancomycin treatment failure is encountered Daptomycin, 6 mg/kg once daily (or every other day for creatinine clearance < 30 mL/min), is approved by the FDA for treatment of S aureus bacteremia and is an alternative to vancomycin, especially if a -lactam cannot be used or if the patient is not responding to vancomycin Cases of vancomycin treatment failures in which the staphylococcal isolate exhibits a vancomycin MIC 4 mcg/mL should be reported to the Centers for Disease Control and Prevention (CDC) to help track this potentially serious and emerging problem of vancomycin resistance Empiric therapy of suspected staphylococcal infection, whether of community or hospital onset, depends on the severity of the infection and the likelihood that it is caused by methicillin-resistant strains If the prevalence exceeds 5 10% for more seriously ill patients, initial therapy should include vancomycin, 1 g intravenously every 12 hours, until results of susceptibility tests are known Resistance to vancomycin fortunately remains rare and should not affect the choice of empiric therapy
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Fowler VG Jr et al S aureus Endocarditis and Bacteremia Study Group Daptomycin versus standard therapy for bacteremia and endocarditis caused by Staphylococcus aureus N Engl J Med 2006 Aug 17;355(7):653 65 [PMID: 16914701] Hidayat LK et al High-dose vancomycin therapy for methicillin-resistant Staphylococcus aureus infections: efficacy and toxicity Arch Intern Med 2006 Oct 23;166(19):2138 44 [PMID: 17060545]
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