ABSTRACT
A 36-year-old woman presented to the emergency department with right hip pain of one week's duration. An x-ray of the hip was unremarkable. She was diagnosed with trochanteric bursitis, given ibuprofen (800 mg tid) and crutches, and sent home. The next day, continual pain and progressive functional impairment prompted her to see an orthopedist. He concurred with the initial diagnosis and administered a corticosteroid injection into the right trochanteric bursa. Propoxyphene (65 mg q4h prn) was added to her medical regimen, and she was again sent home. Pain developed in the right sacroiliac area the next day. Within 24 hours, the right shoulder and right sternoclavicular joint were also involved, and the patient began having subjective fever and chilliness. She returned to the orthopedist and was immediately referred to a rheumatologist who ordered blood cultures and admitted her to the hospital.
Subject(s)
Arthritis, Infectious/diagnosis , Bacteremia/diagnosis , Dilatation and Curettage/adverse effects , Mitral Valve Prolapse/complications , Pain, Postoperative/diagnosis , Streptococcal Infections/diagnosis , Streptococcus agalactiae , Adult , Arthritis, Infectious/etiology , Bacteremia/etiology , Female , Humans , Mitral Valve Insufficiency/complications , Pain, Postoperative/etiology , Streptococcal Infections/etiologyABSTRACT
A 60-year-old man was admitted to the hospital for elective cardiac catheterization. He had had two myocardial infarctions (MI) one and two months earlier. After the second MI, he had been treated with tissue plasminogen activator and heparin. Since then, his blood urea nitrogen concentration had increased from 20 to 63 mg/dL and his blood creatinine concentration from 1.2 to 9.2 mg/dL.
