Clinical and radiological features of neonatal septic arthritis

Fourteen neonates (first 28 days of life) with septic arthritis were admitted into the neonatal unit of the University of Benin Teaching Hospital over a three year period. The incidence was 6.1 per 1000 admissions. Eight were fullterm, three preterm and two low-birthweight babies. Severe constitutional symptoms consisting of fever (temp. 39 degrees C), abdominal distension and jaundice were uniformly present. The aetiologic agents included Staphylococcus aureus (6), Proteus mirabilis (2), and beta haemolytic streptococcus (1), no pathogen was isolated in five patients. There was a possible causal relationship between repeated traumatic femoral venepuncture of the hip in three infants. The early radiologic changes were deep soft tissue swelling, obliteration of fascial plances and widened joint space. Residual damage of the hip joint was noted in one neonate; four died. It is suggested that toxic-looking new-born infants, suspected of septicaemia by examined radiologically for possible arthritis.