A case report of MRSA osteomyelitis following internal fixation of a tibial fracture.

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A 58-year-old woman was admitted to our hospital for treatment of a tibial shaft fracture. Open reduction and internal fixation with plate and screws were performed 5 days after injury. Six weeks after surgery, swelling appeared around the operation scar. Aspirated fluid from the swollen area revealed an infection with Gram-positeve cocci. Continuous irrigation and drainage were immediately performed. Three days later, MRSA was detected in the culture supernatant of the aspirated fluid. The plate and screws were then removed, and continuous irrigation with minocycline started. Simultaneously, VCM was administered intravenously for 11 days, with ABK following for 5 day. Three days after the start of treatment, MRSA vanished from the drainage fluid. Irrigation was continued for 25 days. In this case, clinical symptoms were moderate and laboratory data showed almost normal values which are characteristic features of MRSA infecion.