Abstract
A 54-year-old man with end-stage renal disease presented with chest pain. Five months before presentation the patient had a right-foot cellulitis that was treated with amoxicillin clavulanate. Two weeks later, the patient suffered an inferior wall ST-elevation myocardial infarction that required immediate percutaneous coronary intervention with paclitaxel-eluting stents (Taxus, Boston Scientific, Natick, Mass) in the proximal and mid-right coronary artery (RCA). Over the next 4 months, the patient had recurrent fevers and grew Staphylococcus aureus on repeat blood cultures. The source of infection was attributed to recurrent infected dialysis catheters. The patient had 3 catheter replacements and was treated with intravenous vancomycin and oral rifampin. On examination, the patient had a continuous murmur along the right sternal border and an elevated troponin I level of 2.45 …
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