Ohta R, Shigetaka T, Sano C. Migratory Deposition of Calcium Pyrophosphate in an Older Patient With Several Femoral Neck Implant Infection Episodes: A Case Report.
Cureus 2023;
15:e50815. [PMID:
38249176 PMCID:
PMC10797222 DOI:
10.7759/cureus.50815]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 01/23/2024] Open
Abstract
This case report describes an 86-year-old female patient who presented with complex post-surgical complications following orthopedic surgery for a femoral neck fracture. Initially diagnosed with septic shock due to methicillin-resistant Staphylococcus aureus (MRSA) bacteremia at the surgical site, the patient's treatment course was complicated, involving multiple hospital transfers and varying treatments, including antibiotics and surgical drainage. Despite the absence of infection indicators post treatment, the patient later developed severe thigh pain and was found to have migratory pseudogout, an unusual diagnosis in the context of MRSA and post-surgical complications. This report emphasizes the diagnostic challenges in distinguishing between surgical site infections and other inflammatory conditions like migratory pseudogout, particularly in older patients with comorbidities. It underscores the importance of comprehensive evaluations and the need for general physicians to maintain a broad differential diagnosis when managing post-surgical infections. The case highlights the persistence and recurrence risk of MRSA infections, even post-appropriate antibiotic therapy, and the necessity of considering migratory pseudogout in patients with recurrent infections and systemic soft tissue involvement. The insights from this case contribute to the understanding of complex post-surgical complications and advocate for meticulous assessment and tailored treatment strategies in similar clinical scenarios.
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