Pediatric Patient with Septic Arthritis and Necrotising Fascitis: A Case Report

Septic arthritis comprises pathological invasion of the joint space followed by inflammation. Predisposing risk factors include prior rheumatic joint disease, people at the extremes of age, such as young children and elderly people who have joint prostheses. Although generally bacterial, the etiology can also be viral or fungal. Staphylococcus and streptococcus are common bacteria that cause an acute septic arthritis. However, streptococcus has been emerged as the second most frequent causative agent for septic arthritis. According to a few case reports, septic arthritis of the joint may be found to be associated with necrotising fasciitis.

A 10-year-old male child presented with a history of pain and swelling in the left arm and left shoulder from 3 to 4 days. His mother gave a history of a fall while playing 6 days back. Swelling was grossly increased on day 2 with erythema and induration over the whole of the left arm and shoulder. X-ray image showed soft-tissue swelling of the left arm. On Ultrasonography, a hypoechoic collection noted in the anterior compartment of the entire left arm just above the elbow joint.

This case highlights the importance of thorough assessment in primary care, which led to the high index of suspicion of septic arthritis and necrotising soft-tissue infection and timely management of the patient.