A rare case of severely elevated septic parameters caused by intercurrent juvenile rheumatoid arthritis despite dual trauma surgery. Issue 4 (12th April 2023)

• Record Type: Journal Article
• Authors: Wurm, Lennard M; Andresen, Julian R; Reinke, Justyna; Poddubnyy, Denis; Ertel, Wolfgang; Jagielski, Michal W
• Is Part Of: Journal of surgical case reports. Volume 2023:Issue 4(2023)
• Publication Date: 2023-04-12
• Subjects: infection parameters -- juvenile idiopathic arthritis -- trauma surgery -- procalcitonin; Surgery -- Periodicals; Surgery -- Case studies -- Periodicals; 617.005
• DOI: 10.1093/jscr/rjad168
• Languages: English
• ISSNs: 2042-8812

Abstract

Abstract: Procalcitonin (PCT) and C-reactive protein (CRP) are considered markers used in clinical practice to differentiate bacterial infections from autoimmune origin. Here we evaluate a rare case of a male patient diagnosed with juvenile idiopathic arthritis. The patient presented repeatedly to our department with atraumatic femoral head necrosis, traumatic medial femoral neck fracture and peri-implant femoral fracture. While undergoing repeated surgical interventions including a removal of osteosynthesis material and total endoprosthesis of his right hip including double subtrochanteric osteotomy, the patient developed drastically increasing infection parameters of PCT and CRP. After a completely inconspicuous revision we revealed the untypical genesis of a rheumatic cause. Consequently, we emphasize this etiology to be considered in further decision making for trauma surgery.