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Published on: August 12, 2020
Elbow septic arthritis in an infant: an unusual presentation of invasive pneumococcal disease
Paula Santos1, Catarina Gouveia2, Joana Ovídio3
1Pediatrics, Centro Hospitalar do Médio Tejo, Hospital Rainha Santa Isabel, Torres Novas, Portugal paula.sofia89@gmail.com.
Insights
Acute septic arthritis requires prompt treatment. In infants, Streptococcus pneumoniae infection, even from non-vaccine serotypes, can cause joint issues, necessitating careful antibiotic selection.
Area of Science:
- Infectious Diseases
- Pediatrics
- Microbiology
Background:
- Acute septic arthritis is a severe joint infection demanding immediate intervention to prevent long-term complications.
- Antibiotic selection for septic arthritis typically targets common pathogens but can be influenced by patient demographics and local epidemiology.
Observation:
- A case of elbow arthritis in an infant was observed.
- Streptococcus pneumoniae serotype 9N was identified in both blood and synovial fluid samples from the affected infant.
Findings:
- The infant received arthrocentesis and a course of ampicillin followed by amoxicillin.
- Successful treatment resulted in a favorable response and no lasting sequelae at one-year follow-up.
Implications:
- This case highlights an unusual presentation of invasive pneumococcal disease in a healthy, immunized infant caused by a non-vaccine serotype.
- Clinicians should consider Streptococcus pneumoniae in the differential diagnosis of joint infections, particularly in infants and those with preceding respiratory symptoms.
Abstract:
Acute septic arthritis is a rare, potentially severe infection that requires immediate treatment to avoid long-term morbidity. Most common aetiological agents are commonly used for empirical treatment, but the choice of antibiotics may be influenced by other factors, such as the patient's age and the epidemiological context.We report an infant with elbow arthritis, whose treatment was changed after Streptococcus pneumoniae serotype 9N was isolated in the blood and synovial fluid. The child underwent arthrocentesis and received intravenous ampicillin followed by oral amoxicillin, with a favourable response and no sequelae at 1-year follow-up.We report an uncommon manifestation of invasive pneumococcal disease in a young immunised healthy infant caused by a non-vaccine serotype. The presence of S. pneumoniae should be considered in joint infections, especially in infants and those with a history of respiratory symptoms.
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