A patient with an infected vascular graft may develop hypertrophic osteoarthropathy (HOA) with recurrent episodes of sepsis. Failure to diagnose and manage optimally results in increased morbidity and mortality.
Clinical features:
(1) The patient has a history of surgery with a vascular graft.
(2) The patient develops a hypertrophic osteoarthropathy, which may be limited to a single extremity.
(3) The patient has episodes of recurrent sepsis.
(4) There may be evidence of an enteroprosthetic fistula.
Features of hypertrophic osteoarthropathy may include:
(1) periostitis
(2) synovial effusion
(3) digital clubbing
(4) variable swelling of the affected limb
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