A 79-year-old patient developed nontender lesions on the legs a few days after he began undergoing IV vancomycin therapy to cure acute bacterial endocarditis. The lesions showed signs suggesting a cutaneous infarct that could have been casued by infectious embolic lesions. Infectious emboli, in turn, develop due to infection with Neisseria meningitidis, Neisseria gonorhoeae, S aureus and gram-negative bacilli of the Enterobacteriaceae family.

These nontender lesions developed on the legs of a 79-year-old man 4 days after initiation of IV vancomycin therapy for acute bacterial endocarditis due to Staphylococcus aureus infection. There were numerous petechiae and palpable purpuric lesions ...