The case is that of 52 year Caucasian male with motor vehicle accident, status post open reduction and internal fixation of the left hip. He sustained wound infection with osteomyelitis due to multidrug resistant pseudomonas infection. Extensive debridement of the wound was carried out but the hardware was left in place. He underwent treatment with polymyxin antibiotic for a month then the course was complicated by renal failure which resolved with polymyxin dose adjustment. However, the hard ware was removed after 2 months of treatment. At that time wound culture revealed MRSA infection. He received 4 weeks of Vancomycin and 6 week course of polymyxin after the hardware was removal. He was readmitted to the hospital with increasing pain and persistent drainage from the wound. Imagings were consistent with erosion of the femoral head with joint space loss, and septic arthritis with evidence of osteomyelitis and the presence of sinus tract to the skin surface. Wash out of the wound with debridement was carried out and another course of Vancomycin was instituted.