Missed Wrist Septic Arthritis: A Cautionary Case Report in a Postpartum Patient With Complement Deficiency

A 38-year-old female, only known for beta-thalassemia minor trait, presented 3.5 weeks postpartum with six days of worsening right wrist pain and sepsis. Initial misdiagnosis resulted in delayed surgical debridement of her wrist after two months. Additionally, a concurrent orbital pre-septal cellulitis with different bacteria aided in the diagnosis of an underlying postpartum complement deficiency predisposing her to multiple infections with different organisms in the acute postpartum period. Follow-up at one year and eight years demonstrated significant functional limitations, reduced range of motion, and radiographic evidence of pan-carpal destructive arthropathy with fusion of the carpus. Septic arthritis is a surgical emergency; however, postpartum immunodeficiency is an unreported condition that must be recognized due to the risk of developing multisystem infections and may lead to delayed treatment with devastating sequelae.