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While safer than warfarin, it still carries bleeding risks, including epistaxis, which is commonly managed with nasal packing. We report a 75\u2010year\u2010old woman on apixaban who developed methicillin\u2010resistant\n Staphylococcus aureus<\/jats:italic>\n (MRSA) bacteremia after nasal packing for epistaxis. She presented a few weeks later with worsening back pain and was diagnosed with L2\u2010L3 vertebral osteomyelitis from MRSA. 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