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November 22, 1947


Author Affiliations

New York

From the Department of Surgery, Columbia University and the Surgical Service of the Presbyterian Hospital.

JAMA. 1947;135(12):747-749. doi:10.1001/jama.1947.02890120001001

On Oct. 5, 1936, a leading orthopedic surgeon of New York opened the hip joint of an 11 year old boy in order to reduce the deformity resulting from a traumatic separation of the epiphysis of the neck of the femur. The operative procedure went smoothly; the wound was closed without drainage; a plaster spica was applied, and the boy was returned to the ward in good condition. However, twenty-four hours later he suddenly had a chill accompanied by a sharp rise in temperature and pulse rate, and appeared acutely ill. Inspection of the wound area disclosed no abnormalities, but a blood culture showed heavy growth of hemolytic streptococci. The surgeon was thus confronted with the problem of a fulminating hemolytic streptococcus infection, presumably originating at the operative site, with invasion of the blood stream and with every prospect of a fatal outcome; should a miraculous recovery from the outcome;

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