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Late septic hip dislocation with multifocal osteomyelitis and malaria: a case report
T Sreenivas1, Jagdish Menon2, A R Nataraj2
1Department of Orthopedics, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Dhanvantrinagar, Pondicherry, 605006, India. sreenivas6@rediffmail.com.
Summary
A pediatric patient with MRSA hip infection and malaria experienced hip dislocation and osteomyelitis. Treatment involved antibiotics, antimalarials, surgery, and hip spica, resulting in infection resolution but a stiff hip.
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
Background:
- A 9-year-old boy presented with symptoms suggestive of septic arthritis.
- Initial presentation included fever, right hip pain, and swelling.
Purpose of the Study:
- To describe a complex pediatric case involving concurrent hip infection and malaria.
- To outline the management of hip dislocation and osteomyelitis secondary to infection.
Main Methods:
- Emergency arthrotomy for hip joint pus drainage.
- Intravenous antibiotics for Methicillin-resistant Staphylococcus aureus (MRSA) and antimalarial treatment.
- Closed reduction and hip spica application for posterior hip dislocation and osteomyelitis.
Main Results:
- Successful treatment of MRSA hip infection and Plasmodium falciparum malaria.
- Development of posterior hip dislocation and proximal femur osteomyelitis.
- Fair clinical outcome with infection resolution and a stiff hip post-treatment.
Conclusions:
- Concurrent infections can complicate pediatric orthopedic cases.
- Prompt management of septic arthritis is crucial, but complications like dislocation and osteomyelitis can still occur.
- Multifaceted treatment approaches are necessary for complex pediatric orthopedic and infectious challenges.