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Septic arthritis in early infancy
Insights
Septic arthritis in infants is rare but serious. Early diagnosis and prompt antibiotic treatment are crucial to prevent long-term complications like leg length discrepancies.
Area of Science:
- Pediatrics
- Infectious Diseases
- Orthopedic Surgery
Background:
- Septic arthritis in infants under two months is uncommon.
- This study reviews eighteen cases diagnosed over seven years.
Purpose of the Study:
- To analyze the clinical characteristics, pathogens, and outcomes of infantile septic arthritis.
- To emphasize the importance of early diagnosis and treatment for preventing sequelae.
Main Methods:
- Retrospective case series analysis.
- Review of medical records for diagnosis, symptoms, affected joints, pathogens, and treatment outcomes.
Main Results:
- The hip was the most commonly affected joint (55% had osteomyelitis).
- Staphylococcus aureus and group B Streptococcus were predominant pathogens.
- Total parenteral nutrition was a predisposing factor in S. aureus cases.
Conclusions:
- Early diagnosis and prompt antibiotic therapy are vital for preventing disabling sequelae.
- Open drainage is recommended for hip and shoulder septic arthritis.
Abstract:
Septic arthritis in infants who are less than two months of age is a rare condition. During a recent seven-year period, eighteen cases of infantile septic arthritis were diagnosed at Mackay Memorial Hospital. The ratio of males to females was 1.6:1. The most common symptoms were crying during diaper change, and an immobile and swollen joint. Nonspecific symptoms such as fever, poor appetite and lethargy were uncommon. The hip was the most commonly affected joint with the knee taking second place. Ten cases (55%) demonstrated concomitant osteomyelitis. A bacterial etiology was established in 16 cases (88%). The predominant pathogens were S. aureus (5 cases) followed by group B streptococcus (4 cases). Total parenteral nutrition was the predisposing factor of infection in 4 of the 5 S. aureus arthritis cases. The duration of treatment ranged from 21 to 44 days. Two patients developed sequelae: namely discrepancies in leg length, and a limping gait. Early diagnosis and prompt antibiotic treatment are crucial elements in the prevention of disabling and catastrophic sequelae in young infants who have septic arthritis. In addition, open drainage is highly recommended in hip and shoulder arthritis.
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