--- a +++ b/data/text/es-S1130-63432013000400011-2.txt @@ -0,0 +1,6 @@ +A 62-year-old man with long-standing type 2 diabetes mellitus secondary to chronic calcific pancreatitis with a tendency to hypoglycaemia due to the administration of rapid insulin, multiple admissions for urinary infectious conditions and functional deterioration. +On admission, he suffered from neglect of personal hygiene with uncontrolled elimination habits, malnutrition, chronic renal failure, diabetic ketoacidosis and a grade III sacral ulcer. +Culture of the ulcer exudate showed that it was positive for MRSA and methicillin-resistant Staphylococcus aureus (MRSA) and the antibiogram showed that MRSA was sensitive only to colistin (MIC < 2) and intermediate to amikacin (MIC = 16). MRSA was sensitive to co-trimoxazole (MIC < 1/19) and intermediate to clindamycin (MIC = 1.9). +Treatment was initiated with colistin cream 0.1% with daily application to the dressing and oral cotrimoxazole 800/160 mg every 12 hours for MRSA treatment. After one month of treatment, a favourable clinical evolution of the ulcer was observed, with growth of edges and granulation tissue, which had not been observed prior to topical treatment. +The patient died due to chronic renal failure exacerbated by urinary sepsis, for which reason a post-treatment culture was not available. +