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Septic hip dislocation in a child
Kuo-Shu Hua1, Yun-Yi Huang, Dong-Lin Shen
1Department of Orthopedic Surgery, Changhua Christian Hospital, Changhua, Taiwan, China.
Insights
A pediatric hip dislocation with a large abscess caused by Streptococcus pneumoniae was successfully treated with surgery and antibiotics. However, the patient experienced persistent hip damage two years post-treatment.
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
Background:
- Septic arthritis of the hip is a serious condition in children.
- Prompt diagnosis and treatment are crucial to prevent long-term complications.
Observation:
- A 4-year-old girl presented with acute hip pain, fever, and signs of upper respiratory infection.
- Pelvic CT revealed a dislocated right hip with a large intrapelvic abscess.
Findings:
- Pus culture identified Streptococcus pneumoniae as the causative agent.
- The patient underwent emergency arthrotomy, abscess drainage, hip reduction, and a hip spica cast.
- Intravenous antibiotics were administered for six weeks, leading to infection resolution.
Implications:
- This case highlights the importance of considering septic arthritis in children with hip pain and fever.
- Despite successful infection control, significant hip damage persisted, emphasizing the need for further research into long-term outcomes and management strategies for pediatric hip infections.
Abstract:
A 4-year-old girl presented with pain and disability of right side hip of about 1-week duration. High-grade fever and upper respiratory tract infection were also noted. A pelvic computed tomography scan showed a dislocated hip accompanied by a huge intrapelvic abscess. Culture of pus from the hip showed Streptococcus pneumonia. Emergency arthrotomy, drainage of abscess and reduction of hip, and immobilization with a hip spica cast were undertaken. Thereafter, intravenous antibiotics were given for 6 weeks. The infection was resolved. At a 2-year follow-up, the clinical result was fair and the radiography showed persisting hip damage.