Monday, May 29, 2023
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CME/CE Released: 5/31/2011
Valid for credit through: 5/31/2012
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Ben is a healthy 45-year-old man who was an accomplished high school athlete. He lettered in several varsity sports and played
football at a small Midwestern college. Ten days ago he underwent an uncomplicated total arthroplasty of his left knee. On
admission, he had a positive nasal swab for methicillin-resistant Staphylococcus aureus (MRSA) but he has no history of MRSA infection. His hospital course was uneventful and he was discharged on hospital day
4. Three days after discharge from the hospital he began outpatient rehabilitation and made good progress, eventually regaining
full function of his knee.
Ben presents to a primary care clinic today for a previously scheduled wellness appointment. Although he has a follow-up appointment with his surgeon next week, Ben asks the primary care provider to look at his left knee. Last night, he noticed a small amount of clear drainage from the surgical site and he says that the area is redder than it was the day before. Ben's temperature is 98.6° F (37° C), blood pressure 140/88 mm Hg, and pulse 84 beats/min. On examination, the primary care provider observes minimal erythema around the incision with no swelling, tenderness, or fluctuance and notes a small area of dehiscence, from which a scant amount of purulent drainage is manually expressed.
