Jerry is a 58-year old engineer who was involved in a serious road traffic accident (RTA) 3 months ago. He sustained 4 fractured ribs, a subdural haematoma, a splenic laceration requiring splenectomy and a compound fracture of his right femur. He spent 5 weeks in ICU and was ventilated for adult respiratory distress syndrome (ARDS). This was followed by 3 weeks in the orthopaedic ward for management of his fractured femur and a wound infection due to E.coli, treated with oral co-amoxiclav.
At outpatients 4 wees after discharge from hospital, Jerry is apyrexial but there is some discharge from the leg wound site where an intramedullary nail was inserted, and he complains of a dull ache for the last couple of days. A wound swab indicates that Staphlococcus aureus (S.aureus) is isolated with antibiotic susceptibility results to follow. Jerry is on no antibiotics since discharge
Is it surprising that Jerry is on no antibiotics whatsoever?
What is the significance of the S. aureus?
What does the image below show?
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