[Clinical analyses of septic arthritis in neonates]

To explore the clinical features, the diagnostic and therapeutic strategies and different inflammatory indices for neonatal septic arthritis.

Clinical presentations, laboratory findings, treatment and prognosis of patients with neonatal septic arthritis hospitalized from October 2009 to December 2013 were analyzed retrospectively.

Among 19 cases with septic arthritis in neonates, the sites were hip (n = 8), knee (n = 7) and shoulder (n = 4). And 13 cases had fever. Joint swelling, tenderness, skin temperature and activity limitation were absent in 9 cases. At initial presentations, the positive rates of C-reactive protein (CPR) and procalcitonin (PCT) were 63.2% and 83.3% respectively. And the differences were statistically significant (P < 0.05). At Day 1 after admission, the positive rates of CRP, PCT and erythrocyte sedimentation rate (ESR) were 100%, 100% and 41.6% respectively. No difference existed in positive rate between CPR and PCT (P > 0.05). The positive rate of ESR was lower than CPR and PCT and the difference was statistically significant (P < 0.05). Radiographic examination showed swelling of joint capsule, joint space widening and swelling of joint soft tissue. All were cured and discharged through intravenous antibiotic therapy. 16 cases were followed-up, except for 1 patient with hip disease due to poor rational dislocation motion. And the others were normal.

Neonatal septic arthritis should receive priority attention. With early diagnosis and standard treatment, the prognosis is usually good.