Knee Pain And Fever In A Cross Country Runner - Page #3
 

Lab Studies:
WBC 1.4, Hgb 12.6, Hct 37, Plts 82, Na 138, K 4.3, Cl 116, HCO3 15, BUN 26, Cr 1.61, glucose 141, Ca 7.0, CRP 16.9, ESR 10, INR >10.0, PTT >200.0, pH 7.14, CO2 63, lactate 7.1, and CPK 38464.

Other Studies:
Chest x-ray demonstrated bilateral patchy infiltrates with pulmonary edema and small bilateral pleural effusions.Case Photo #1 Echocardiogram showed moderately to severely depressed biventricular function. Blood cultures from the outside hospital and our facility ultimately grew methicillin-resistant Staphylococcus Aureus (MRSA) also resistant to erythromycin and levofloxacin, but sensitive to clindamycin, doxycycline, gentamicin, rifampin, trimethoprim-sulfamethoxazole, and vancomycin. Subsequent imaging demonstrated R femur osteomyelitis, periosteal abscess, and pyomyositis.Case Photo #2, Case Photo #3

Consultations:
Pediatric orthopedics, infectious disease, cardiology, nephrology, and critical care.

Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.


NOTE: For more information, please contact the AMSSM, 11639 Earnshaw, Overland Park, KS 66210, (913) 327-1415.
 

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Phone: 913.327.1415


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