Gas Gangrene of a Prosthetic Hip

November 13, 2014 at 8:53 am

N Engl J of Med Nov. 2014

IMAGES IN CLINICAL MEDICINE

John C. Kurylo, M.D., and Andrew H. Schmidt, M.D.

Hennepin County Medical Center, Minneapolis, MN

john.kurylo.md@gmail.com

An 82-year-old man with diabetes mellitus who had undergone a total hip replacement 10 years earlier presented to the emergency department with the acute onset of pain in the left hip and groin and a fever (temperature, 39.2°C).

On presentation, the blood pressure was 96/57 mm Hg, and the white-cell count was 12,400 per cubic milliliter.

A radiograph and subsequent computed tomographic scan of the hip (Panels A and B, respectively) showed free air extending lateral to the greater trochanter and superior to the acetabular component.

Broad-spectrum antibiotic therapy was initiated, and the patient underwent emergency surgical débridement with removal of the acetabular component; intra-articular cultures grew Clostridium septicum….

PDF

http://www.nejm.org/doi/pdf/10.1056/NEJMicm1400498

 

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, FIEBRE en el POSTOPERATORIO, Health Care-Associated Infections, Images in Clinical Medicine, Infecciones nosocomiales, Infecciones osteo-articulares-musculares, Metodos diagnosticos, Sepsis. Tags: .

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