PMC4857327_01
(a) On initial admission, enhanced CT revealed aortic dissection from the ascending (left arrow) to descending (right arrow) aorta and (b) on the third admission, CT scanning revealed an abscess around the artificial ascending aorta (arrows).
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Enhanced computed tomography (CT) revealed dissection of the ascending aorta (Figure 1(a)). CT scanning revealed an abscess around the artificial ascending aorta (Figure 1(b)).
Clinical course of the first admission. Bars indicate duration of various anti-MRSA drug administrations.. EM: erythromycin; RFP: rifampicin; ABK: arbekacin; TEIC: teicoplanin; VCM: vancomycin; LZD: linezolid; HD: hemodialysis therapy; Ope 1: ascending aorta replacement; 2: femoral-femoral artery bypass; 3: amputation of the left leg; 4: right subclavian-femoral artery bypass; WBC: white blood cell; CRP: C-reactive protein..   MRSA-positive blood culture..   MRSA-negative blood culture.
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The patient was discharged in July 2010 (the 390th hospital day) for outpatient follow-up care (Figure 2).
CT scanning due to left hemiplegia revealed brain abscess (arrows).
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In February 2011, the patient was readmitted to the hospital because of left hemiplegia due to a brain abscess (Figure 3).
Gallium-67 scintigraphy revealed accumulation in the spleen and right kidney. The image is indicative of splenic abscess (right arrow) and pyelitis of the right kidney (left arrow).
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To detect the focus of the MRSA infection, Gallium-67 scintigraphy was performed; abnormal uptake was detected in the spleen and right kidney (Figure 4).
Clinical course of the second and third admissions. Bars indicate duration of various anti-MRSA drug administrations.. EM: erythromycin; RFP: rifampicin; ABK: arbekacin; TEIC: teicoplanin; VCM: vancomycin; LZD: linezolid; DAP: daptomycin; HD: hemodialysis therapy; Ope 5: craniotomy for brain abscess excision; WBC: white blood cell; CRP: C-reactive protein..   MRSA-positive blood culture..   MRSA-negative blood culture.
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At home, fever was observed again, and the patient was readmitted to the hospital in January 2012 (Figure 5). Despite all treatment efforts, the patient expired in April 2012 (Figure 5).