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Septic Arthritis in Children: A Medical Emergency

MMZ Islam* , MMZ Islam* , SMK Mahmood** , MK Hasan***

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Indian Journal of Trauma and Emergency Pediatrics 9(1):p 57-61, January-March 2017. | DOI: DOI: http://dx.doi.org/10.21088/ijtep.2348.9987.9117.10

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Abstract

 Septic arthritis (SA) in children is considered as a medical emergency. If untread, it may destroy the joint in a period of days. The infection may also spread to other parts of the body. SA results from bacterial invasion of the joint space through the blood stream, from adjacent osteomyelitis, or through direct inoculation of the wound. Staphylococcus aureus is the most common cause of SA in all age group. Among those aged 15-50 years, Neisseria gonorrhoea runs a close second. Pain with an infected joint typically present with triad of fever (40-60% of cases) pain (75%of cases), and impaired range of motion. SA is a challenging clinical problem because: (1) signs and symptoms may be subtle and overlap with those found in other condition, (2) screening laboratory studies and synovial fluid cultures are relatively insensitive, and (3) optimal management, including duration of antibiotics therapy and surgical approach is not evidence based. Diagnosis of SA is based on a combination of clinical findings and results of synovial fluid analysis. Imaging studies is insensitive in the diagnosis of SA. All children presumed to have SA should be hospitalized for empiric intravenous antibiotic therapy. In general, 3-4 weeks to treat staphylococcus aureus, H. influenzae type B, or Strep. Pneumoniae infections, while gonococcal infections are treated for 7-10 days. Close follow up with physical examinations and laboratory tests must be done to make sure that patients remain afebrile, pain resolved, improved range of motion, and normalize laboratory values.

Keyword: Septic Arthritis; Microorganism; Synovial Fluid.

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DOI: DOI: http://dx.doi.org/10.21088/ijtep.2348.9987.9117.10

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