ABSTRACT
Under certain circumstances, patients with a prosthetic joint and a focal infection elsewhere in the body may be at risk of developing bacterial infection of the prosthesis. Patients and physicians should actively prevent infections that can spread systemically. Routine antibiotic prophylaxis is not recommended for all patients with a prosthetic joint and suspected bacteraemia. Antibiotic prophylaxis is warranted in three groups of patients with a prosthetic joint who must undergo an invasive procedure that could cause bacteraemia: patients with a predisposing immunocompromising systemic condition or those receiving immunosuppressive therapy, patients with a dermatological infection, and patients with an obvious focal infection, e.g., urosepsis. If the patient is already receiving antibiotics for the infection, additional prophylaxis is usually unnecessary. For patients undergoing dental procedures who require antibiotic prophylaxis, amoxicillin-clavulanic acid or clindamycin are preferred.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacteremia/prevention & control , Joint Prosthesis , Practice Patterns, Physicians' , Prosthesis-Related Infections/prevention & control , Antibiotic Prophylaxis , Humans , Immunocompromised Host , Joint Prosthesis/microbiology , Risk Assessment , Risk FactorsABSTRACT
This article describes a 69-year-old man with a bilateral total knee prosthesis in whom both knees were swollen and painful. Fever was present and the levels of inflammation markers were markedly elevated. Gout was diagnosed in the right knee and haemarthros during calcium carbasalate use in the left knee. Gout in a knee with a total knee prosthesis is rare and can mimic septic arthritis. Early diagnosis is of particular importance as the therapy of the two conditions differs considerably. Gout is treated with medication while surgical treatment is necessary in a case of septic arthritis, which may even involve removal of the prosthesis.
Subject(s)
Arthritis, Gouty/diagnosis , Arthroplasty, Replacement, Knee , Aged , Arthritis, Infectious/diagnosis , Arthroplasty, Replacement, Knee/adverse effects , Diagnosis, Differential , Humans , MaleABSTRACT
Transdiaphragmatic hernia most often develops after blunt or penetrating thoracoabdominal trauma. We report on the case of a 73-year-old man who underwent emergency ileocoecal resection for an incarcerated transdiaphragmatic intercostal hernia. The patient's history included both a lumbotomy for right nephrectomy and Chilaiditi's syndrome. The literature regarding both transdiaphragmatic intercostal herniation and Chilaiditi's syndrome is reviewed in relation to the presented case.
Subject(s)
Colon/abnormalities , Congenital Abnormalities/diagnosis , Hernia, Diaphragmatic/pathology , Hernia, Diaphragmatic/surgery , Laparotomy/methods , Aged , Anastomosis, Surgical , Cecum/surgery , Emergency Treatment , Follow-Up Studies , Hernia, Diaphragmatic/diagnostic imaging , Humans , Ileum/surgery , Male , Risk Assessment , Severity of Illness Index , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
A 10-year-old boy had a palpable mass in the left upper abdomen, which at laparotomy was diagnosed as an epidermoid cyst of the spleen.
Subject(s)
Epidermal Cyst/diagnosis , Spleen/surgery , Splenic Diseases/diagnosis , Child , Epidermal Cyst/pathology , Epidermal Cyst/surgery , Humans , Male , Splenectomy , Splenic Diseases/pathology , Splenic Diseases/surgery , Tomography, X-Ray ComputedABSTRACT
Transorbital intracranial injuries are uncommon but classic ophthalmologic traumas. This report describes a case of a woman who was found dead. Postmortem examination revealed a Bic ballpoint which had penetrated her head through her right eye. Detective forces believed a murder to be the most likely cause; however, medical expert consultants indicated that a tragic accident was more likely. The case and the results of crossbow test-firing on human cadavers are presented.