The Girdlestone situation: a historical essay

The eponymous term 'Girdlestone situation' originally referred to an excision of the femoral head in case of an acute pyogenic infection of the hip, described by Gathorne Robert Girdlestone in 1945. Over time the procedure and the indication to perform it have significantly changed. This article presents a short biography of Girdlestone with a concomitant report on investigating the evolution of the indication and technique of the Girdlestone situation from the first description up to contemporary literature.

A Case of Phlegmonous Gastritis in a Patient with Psoriatic Arthritis on Infliximab

Phlegmonous gastritis is a pyogenic infection affecting the submucosa of the gastric wall. Although rarely diagnosed, it remains a disease with high mortality. We thereby describe the case of a 42-year-old male patient known for psoriatic arthritis on Infliximab who was diagnosed with phlegmonous gastritis secondary to immunosuppressive therapy. The patient had a favourable outcome with a conservative treatment consisting of a 14-day course of broad antibiotherapy.

Pyogenic infection of the hip joint as a complication of a femoral artery vascular access for percutaneous coronary intervention

A rare case of clinical complication following a percutaneous coronary intervention is presented. A femoral vascular access was chosen to treat a coronary lesion with a stent implantation. This femoral vascular access, however, resulted in a pyogenic infection of the ipsilateral hip joint that was not properly diagnosed for an extended post-interventional period. The hip joint completely deteriorated before its underlying cause was identified. This case report illustrates the importance of recognizing potential endovascular complications independently of their frequency.

Delayed Surgical Site Infection by Tuberculosis – A Rising Cause of Concern ?

Background: Surgical site infections causes significant morbidity and mortality of patients and causes more difficult to treat if unexpected cause behind the infection like tuberculosis. Delayed surgical site infection after initial healing are uncomfortable for both surgeons and patient.Methods: Wound tissue from 18 patients with delayed surgical site infection not responding to antibiotics used for pyogenic infection were collected and examined histopathologically.Results: Of the 18 patients, 9 revealed histologically tuberculosis, 7 non-specific chronic inflammation and others showed foreign body granulomma. Association between histopathological report and incidence of tuberculosis is significant (p<0.001) and association between onset of infection and incidence of tuberculosis also significant (p<0.05).Conclusion: A high degree of suspicion is required in case of delayed or recurrent surgical site infection to diagnose tuberculosis as a cause.J Bangladesh Coll Phys Surg 2014; 32: 186-189

Melioidosis – A Serious Emerging Threat in Bangladesh

Melioidosis, a pyogenic infection that presents acutely or as a chronic infection, is caused by the soilassociated bacterium Burkholderiapseudomallei. Infection is acquired by inoculation or inhalation and is more common in patients with underlying chronic disease. It is endemic in the tropical belt. Although Bangladesh is not considered as a country where melioidosis is endemic, an increasing number of cases have been reported recently. Definitive diagnosis requires the isolation of B. pseudomalleiin culture from clinical specimens. However, the laboratory diagnosis of melioidosis in Bangladesh and other under-resourced countries is limited by a lack of familiarity with the bacterium and a lack of facilities to accurately confirm the identity of the isolate. It is highly likely that melioidosis is underdiagnosed in this country. There is a need to increase awareness of this infection among clinicians and clinical microbiologists and improve laboratory facilities for the selective isolation and accurate identification of B. pseudomallei. Melioidosis has a notoriously protracted course; cure is difficult without a prolonged course of appropriate antibiotics.DOI: http://dx.doi.org/10.3329/jom.v14i2.19669 J Medicine 2013, 14(2): 164-173