A 59-year-old female with a history of left-hand open reduction with internal fixation developed complicated Pseudomonas and Providencia Osteomyelitis (ICD M86.8X4) requiring debridement, followed by multiple courses of failed oral antibiotics over many months. Ultimately, this patient was referred by the ortho service to nodMD’s infectious diseases (ID) providers for further management. In order to expedite the ID consultation, an ID televideo visit was scheduled. On the day of the scheduled appointment, the patient became extremely anxious and informed nodMD that she was going to the emergency department (ED) for evaluation. nodMD’s physician assistant met the patient in the ED and prevented a hospital admission. The patient was then evaluated by the nodMD physician via televideo and referred to a Home IV Infusion Company for 6 weeks’ treatment with Cefepime 2 Gms IV q12h to be initiated STAT and weekly labs. The Home Infusion Company arranged for PICC insertion at a local hospital outpatient center and initiated home IV Cefepime via peripheral IV that same evening.

Outcome

This patient’s IV Cefepime was discontinued day 24 due to drug side effects. Despite early discontinuance of treatment, the infection has not recurred and no further treatment has been necessary.