Neonatal septic arthritis in a tertiary care hospital: a descriptive study

Sreenivas, T.; Nataraj, A. R.; Kumar, Anand; Menon, Jagdish

doi:10.1007/s00590-016-1776-9

Cited by 22 publications

(27 citation statements)

References 9 publications

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“…reported a population of 29 neonates with SA, mean age at presentation was 23.8 days with a female predominance (58.6%), the common symptoms were fever (100%), involved limb in position of ease/pseudo-paralysis (69.0%), swelling (79.3%) and warmth (75.9%). 7…”

Section: Discussionmentioning

confidence: 99%

Short Therapy in a Septic Arthritis of the Neonatal Hip

et al. 2019

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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.

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Section: Discussionmentioning

confidence: 99%

Short Therapy in a Septic Arthritis of the Neonatal Hip

et al. 2019

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“…In neonatal AOI there is a tendency to involve multiple bone and joint foci, to physeal/epiphyseal destruction and joint dislocation. 39 , 60 The degree of limitation of active/reflex limb motion – pseudoparalysis – with the contralateral side as a comparator, is a very useful but often overlooked clinical tool to establish the diagnosis. This can also be obtained from meticulous history-taking.…”

Section: Diagnostic Challengesmentioning

confidence: 99%

“…These antibiotics may be used empirically if the microbiological epidemiologic profile favours methicillin-susceptible/sensitive Staphylococcus aureus. 8 , 9 , 12 , 14 , 60 , 62 Kingella kingae – a Gram-negative organism – is another notable but more indolent source of acute infections. The recent use of molecular diagnosis with 16S rRNA gene polymerase chain reaction (PCR) and sequencing in synovial fluid has improved its detectability.…”

Section: Management Controversiesmentioning

confidence: 99%

“… 30 , 34 , 62 , 70 Occasionally Gram-negative organisms such as Kingella kingae are the causative agents, especially in neonates, casting doubt on the clinical utility of Gram stain of joint aspirates. 8 , 29 , 32 , 33 , 58 , 60 , 73 Similarly, the lack of rapidly available results from conventional PCR done for commonly encountered pathogens in joint fluid aspirate limits the clinical utility and practicality of current PCR techniques. 74 There has been disagreement in the literature about the route of administration, duration, number and type of antibiotics needed to treat AOI.…”

Section: Management Controversiesmentioning

confidence: 99%

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Acute osteoarticular infections in children are frequently forgotten multidiscipline emergencies: beyond the technical skills

El-Sobky

Mahmoud

2021

EFORT Open Reviews

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Acute osteoarticular infections (AOI) should be treated as top emergencies. The first few days following the inception of infection are ultra-critical to long-term prognosis. A comprehensive road map for management of childhood AOI is still lacking despite recent advances in microbiology and imaging (magnetic resonance imaging). The many faces of childhood AOI warrant a multidiscipline approach to management. Laboratory and imaging findings of are still debatable and should not overshadow or delay a management plan based on the experienced physician’s clinical judgment. Ample evidence-based practice supports the use of a few days of intravenous antibiotic administration followed by oral therapy until correlative clinical and basic laboratory (acute phase reactants) results improve. The growing body of evidence on ‘high-risk’ children/neonates of AOI warrants continual clinical extra-vigilance in identifying these patient subsets. Open drainage and debridement remain the mainstay of treatment of septic hips, whereas for other joints the use of alternative surgical techniques should be individualized or on case-by-case basis. Because the consequences of misdiagnosis of AOI are usually grave and permanent, proactive treatment/overtreatment is justified in the event of unconfirmed but suspicious diagnosis. Cite this article: EFORT Open Rev 2021;6:584-592. DOI: 10.1302/2058-5241.6.200155

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“…It is conceivable that this scenario applies to children as well, although data from the USA suggest no major changes over time [9]. As Asian-Pacific data on SA are sparse and limited to case series [16][17][18][19], the aim of this study was to investigate the state-wide frequency, underlying clinical characteristics and outcomes of incident SA in children in Western Australia (WA) over the period 1990-2010.…”

Section: Introductionmentioning

confidence: 99%

Septic Arthritis in Children: A Longitudinal Population-Based Study in Western Australia

et al. 2021

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Objective To describe the incidence, risk factors and long-term outcomes in children hospitalised with septic arthritis (SA) in Western Australia (WA). Methods We extracted state-wide longitudinally linked administrative health data for patients aged < 16 years with a first diagnostic code of 711.X (ICD9-CM) and M00.X (ICD10-AM) in WA in the period 1990–2010. Annual incidence rates (AIR) per 100,000 with 95% confidence intervals (CIs), prior conditions during a median lookback period of 63.2 [interquartile range (IQR) 19.8–117.1] months and outcomes, including standardised mortality rates (SMR), during a median follow-up of 10 years are reported. Results A total of 891 patients [62% male, median age 6.4 (IQR 1.9–10.6) years with 34% aged < 3 years] were admitted for SA during the observation period. The overall AIR (per 100,000) was 9.85 (95% CI 4.79–14.41), and was higher in Indigenous Australians [34.9 vs. 5.5 (non-Indigenous), p < 0.001] and in males [11.9 vs. 7 (females), p < 0.01]; AIR showed no temporal or seasonal variation. Knees (43.9%), hips (34.6%) and ankles (13.3%) were most frequently affected, with Staphylococci predominant (49%) in patients with positive cultures (41.5%). Prior infection(s) (40.4%) and respiratory disease (7%) were the main pre-existing morbidities. Median hospital stay was 4.0 (IQR 2–8) days, with 1.9% requiring admission to the intensive care unit and 10.4% requiring readmission within 30 days. During follow-up, 26 patients (3.1%) developed osteomyelitis, nine patients were diagnosed with osteoarthrosis (1.1%) and five patients (0.6%) underwent joint replacement. Female patients developed other serious infections more often than male patients (40.5 vs. 27.1%, p < 0.01), as well as other comorbidities (Charlson Comorbidity Index > 0: 34.6 vs. 27.2%, p = 0.02), including diabetes (4.2 vs. 0%; p = 0.001), cardiovascular events (4.2 vs 1.4%, p = 0.002) and chronic arthritis (1 vs. 0%, p = 0.05). The crude mortality rate was low (0.3%), with 99.4% survival at 180 months and no increase in the SMR. Conclusions The incidence of SA in children in WA did not change over the 20-year observation period. SA did not lead to excess mortality, but bone and joint complications developed in 5% of patients. The high propensity to comorbid conditions in this young cohort suggests an underlying role of comorbidity in SA development. Supplementary Information The online version contains supplementary material available at 10.1007/s40744-021-00307-x.

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Neonatal septic arthritis in a tertiary care hospital: a descriptive study

Cited by 22 publications

References 9 publications

Short Therapy in a Septic Arthritis of the Neonatal Hip

Short Therapy in a Septic Arthritis of the Neonatal Hip

Acute osteoarticular infections in children are frequently forgotten multidiscipline emergencies: beyond the technical skills

Septic Arthritis in Children: A Longitudinal Population-Based Study in Western Australia

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