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A Case of Upper Limb Osteomyelitis and Septic Arthritis Presenting as Pseudoparalysis in a Two-Week-Old
1Trauma and Orthopaedics Department, Cambridge University Hospitals Trust, Cambridge, UK.
Insights
Infant pseudoparalysis, often mistaken for Erb
Area of Science:
- Pediatric infectious diseases
- Neonatal care
- Orthopedic surgery
Background:
- Pseudoparalysis in infants is a rare condition with infection and trauma as primary differential diagnoses.
- Early misdiagnosis can occur, as seen in this case where it was initially identified as Erb's palsy.
Observation:
- A two-week-old infant presented with pseudoparalysis, initially misdiagnosed as Erb's palsy.
- The infant later showed signs of sepsis.
Findings:
- Diagnosis revealed humerus osteomyelitis and septic shoulder arthritis.
- Despite treatment, the proximal humerus epiphysis remained abnormal.
- The infant had no functional deficit at four-year follow-up.
Implications:
- Highlights the importance of considering infection in infant pseudoparalysis.
- Emphasizes prompt diagnosis and management of neonatal sepsis and osteomyelitis.
- Suggests potential for good functional recovery despite radiographic abnormalities.
Abstract:
Pseudoparalysis presenting in infants is a rare manifestation, where infection and trauma are the principle differentials. We present a case of a two-week-old baby boy with pseudoparalysis who was initially diagnosed as Erb's palsy when presented in the emergency department and later re-presented with signs of sepsis. A later diagnosis of osteomyelitis of the humerus and septic arthritis of the shoulder was made. Despite antibiotic therapy and surgical drainage, the proximal epiphysis of his humerus remains abnormal; however, he has no apparent functional deficit of his right arm at four-year follow-up.
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