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Discitis Mimicking Septic Arthritis in a 17-Month-Old Boy
Tariq Aziz1, Muneebah Ihsan2, Abdelfatah M Elsenosy3
1Emergency Medicine, University Hospitals Dorset NHS Foundation Trust, Poole, GBR.
Insights
Pediatric discitis, a rare bacterial infection, presents with varied symptoms like refusal to walk, delaying diagnosis. Early antibiotics and monitoring are key for good outcomes in children.
Area of Science:
- Pediatric infectious diseases
- Pediatric orthopedics
- Pediatric radiology
Background:
- Discitis is an uncommon bacterial infection in children aged 2-8 years.
- Clinical presentations vary, often including irritability, refusal to walk, and back pain, leading to diagnostic delays.
Abstract:
Discitis in children is uncommon, typically occurring between the ages of two and eight years. The etiology is not established, but it is generally considered a bacterial infection. Symptoms vary with age but commonly include irritability, refusal to walk, and back pain. These various clinical presentations cause delays in diagnosis. We present this case to draw attention and familiarise clinicians with its presentations. A 17-month-old boy presented with a one-week history of refusal to walk. Examination showed an unusual finding of the child keeping his right leg in a flexed position with hip tenderness. Inflammatory markers were raised. Initially, the patient was managed for suspected septic arthritis of the hip joint. Initial tests were inconclusive, and magnetic resonance imaging (MRI) on day 23 revealed discitis at L4-L5. After a course of antibiotics and monitoring of inflammatory markers, his clinical condition improved. The mainstay of treatment is antibiotics, with surgery reserved for complicated cases. Discitis has a good prognosis in children.
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