Staphylococcus aureus: Blood Infection

David had not been feeling well for the past week. On Friday, 10 April 2015, he was admitted inpatient to Lunder 10 for stomach pain. Since then he’s been on a few IV antibiotics, including vancomycin. Trivia fact for the day: vancomycin was first isolated in 1953 at Eli Lilly & Co. from a soil sample collected by a missionary in the interior jungles of Borneo. It is a naturally occurring antibiotic made by soil bacterium.

A blood culture shows a staphylococcus aureus in the blood. 20% of healthy people have staphylococcus aureus on their skin and/or nasal passages. Because of David’s leukemia, his immune system is very poor and he’s at risk for infections of all types. The normal course of treatment is 2 to 4 weeks of antibiotic via IV. This can be done at home. At this time he is receiving Nafcillin and Flagyl via IV. He’s been taking Flagyl in pill form; now he’s receiving it via IV.

He also has an occlusion (partial obstruction) in his small bowel. It seems to be slowly resolving, but the infectious disease team is monitoring this carefully.

The blood counts are not good. His white blood cell count has quadrupled in 3 days. April 8^th was the last day he was allowed to have hydroxyurea and stay on the clinical trial. As you can see, the white blood counts started rising the next day.

Transfusions are keeping his hematocrit and platelets in the ‘normal’ range for leukemia patients (which is very low compared to healthy people).

Date of Blood Draw (CBC)	White Blood Cell Count	% Blasts in circulation	Absolute Neutrophils	Hematocrit (red blood cells)	Platelets
26-Mar-15	36.29	72.0%	2.18	20.00	23.00
31-Mar-15	18.62	72.0%	2.05	27.70	12.00
2-Apr-15	10.86	68.0%	0.98	25.80	12.00
6-Apr-15	4.91	40.2%	0.57	22.50	9.00
8-Apr-15	6.57	58.0%	0.20	24.50	9.00
10-Apr-15	10.68	83.0%	0.00	24.40	18.00
11-Apr-15	29.41	72.7%	1.62	20.70	14.00
11-Apr-15	38.14	76.0%	0.00	23.10	15.00
12-Apr-15	39.56	77.0%	0.79	21.90	10.00
13-Apr-15	41.60	82.0%	0.83	20.90	33.00