Short therapy in a septic arthritis of the neonatal hip

Septic arthritis (SA) is a serious joint infection associated with significant morbidity that can cause permanent damage with articular cartilage destruction, osteonecrosis and lifelong deformities if not diagnosed and treated promptly. In neonates, because of the paucity of signs and symptoms, SA is difficult to diagnose. The treatment for SA in children is empirical antibiotic for weeks, initially intravenously, and surgical (arthrotomy) in particular for the hip and shoulder because of the high risk of sequelae in these joints. Actually, there isn’t a consensus about the duration of antibiotic treatment, because of the lack of powered studies, and a variable period from 2 weeks to 4 months has been suggested in the literature. Data in the neonatal population are very limited. We describe a case of neonatal hip arthritis with a good outcome treated with a short antibiotic course of 2 weeks.

[1]  J. Menon,et al.  Neonatal septic arthritis in a tertiary care hospital: a descriptive study , 2016, European Journal of Orthopaedic Surgery & Traumatology.

[2]  C. Jo,et al.  The use of ultrasound in the management of septic arthritis of the hip , 2015, Journal of pediatric orthopedics. Part B.

[3]  J. Samora,et al.  Septic Arthritis of the Neonatal Hip: Acute Management and Late Reconstruction , 2013, The Journal of the American Academy of Orthopaedic Surgeons.

[4]  H. Peltola,et al.  Simplifying the treatment of acute bacterial bone and joint infections in children , 2011, Expert review of anti-infective therapy.

[5]  Heikki Peltola,et al.  Short- Versus Long-term Antimicrobial Treatment for Acute Hematogenous Osteomyelitis of Childhood: Prospective, Randomized Trial on 131 Culture-positive Cases , 2010, The Pediatric infectious disease journal.

[6]  D. AnamaríaPeña,et al.  Short duration of initial intravenous treatment in 70 pediatric patients with osteoarticular infections , 2008 .

[7]  M. Rajnik,et al.  Fetal Breech Presentation Predisposes to Subsequent Development of Septic Arthritis of the Hip , 2004, The Pediatric infectious disease journal.

[8]  M. Levine,et al.  Assessment of the Test Characteristics of C-Reactive Protein for Septic Arthritis in Children , 2003, Journal of pediatric orthopedics.

[9]  C. Saltzman,et al.  Pneumococcal septic arthritis: review of 190 cases. , 2003, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[10]  H. Graham,et al.  Duration of antibiotics in children with osteomyelitis and septic arthritis , 2002, Journal of paediatrics and child health.

[11]  F. Jaberi,et al.  Short-Term Intravenous Antibiotic Treatment of Acute Hematogenous Bone and Joint Infection in Children: A Prospective Randomized Trial , 2002, Journal of pediatric orthopedics.

[12]  K. Mukhopadhyay,et al.  Bone and joint infection in neonates , 1998, Indian journal of pediatrics.

[13]  J. R. Bowen,et al.  Sequelae and reconstruction after septic arthritis of the hip in infants. , 1990, The Journal of bone and joint surgery. American volume.

[14]  Anamaría Peña D,et al.  [Short duration of initial intravenous treatment in 70 pediatric patients with osteoarticular infections]. , 2008, Revista chilena de infectologia : organo oficial de la Sociedad Chilena de Infectologia.

[15]  T. Nunn,et al.  A prospective study of pyogenic sepsis of the hip in childhood. , 2007, The Journal of bone and joint surgery. British volume.

[16]  R. Mollan.  Acute septic arthritis in children. , 1976, The Ulster medical journal.