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Etiology of septic arthritis in children: an update for the 1990s

J D Luhmann1, S J Luhmann

  • 1Department of Pediatrics, Washington University School of Medicine, St. Louis 63110-1077, USA. luhmann_j@kidsA1.wustl.edu

Pediatric Emergency Care
|March 9, 1999
PubMed

Insights

Septic arthritis in children is now frequently caused by Staphylococcus aureus, not Haemophilus influenzae type B, following immunization guidelines. Early diagnosis remains a challenge, with many cases initially misdiagnosed.

Area of Science:

  • Pediatric Infectious Diseases
  • Rheumatology
  • Microbiology

Background:

  • Septic arthritis is a serious joint infection in children.
  • Haemophilus influenzae type B (Hib) was a leading cause before widespread immunization.
  • Etiology may have shifted following Hib vaccination campaigns.

Purpose of the Study:

  • To determine the current causes of septic arthritis in children.
  • To assess the impact of Hib immunization on the etiology of pediatric septic arthritis.

Main Methods:

  • Retrospective chart review of pediatric septic arthritis cases (ICD-9: 711).
  • Study period: January 1991 to December 1996 at St. Louis Children's Hospital.
  • Analysis of patient demographics, causative organisms, and diagnostic accuracy.

Main Results:

  • Sixty-four children diagnosed with septic arthritis were identified.
  • Staphylococcus aureus was the most common pathogen (10 isolates).
  • Only one case of Haemophilus influenzae type B was identified in an unimmunized child.

Conclusions:

  • Staphylococcus aureus is a predominant pathogen in pediatric septic arthritis.
  • Haemophilus influenzae type B is no longer the leading cause in immunized children.
  • Septic arthritis in children is often misdiagnosed initially.
Abstract

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