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Associate Professor of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California; Director, Infection Control Program, Harbor-UCLA Medical Center, Torrance, California
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As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.
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Associate Professor of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California; Director, Infection Control Program, Harbor-UCLA Medical Center, Torrance, California
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CME/CE Released: 8/25/2010
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Stella is a 68-year-old, overweight woman with a body mass index of 29.0 kg/m2. She has type 2 diabetes mellitus, hypertension, and hypercholesterolemia. She has a 10-year history of degenerative joint disease of the right hip. After discussion with her primary care physician and an orthopaedic surgeon, she decided to undergo total replacement of her right hip.
A metallic prosthesis fixed with cement was implanted; the surgical procedure was uneventful. After discharge from the hospital, she began physical therapy to regain physical function. Although her mobility gradually improved, 3 weeks after surgery she began to have discomfort and redness at the surgical incision site. At about the same time, she began to experience fatigue and mild sweats, but she did not have a fever. Thinking that she had overexerted herself, she decreased her physical activity, hoping that the discomfort would improve. However, the redness increased and the discomfort persisted. In addition, she noticed that her clothing overlying the incision was damp.
Stella was seen by her primary care physician, who noted that she was afebrile with normal vital signs. On examination, the surgical site was mildly tender to touch, warm, erythematous, and nonfluctuant. There was a small area of dehiscence (Figure 1) from which a small amount of yellow-green discharge was manually expressed.
