Hip involvement in childhood brucellosis.
We reviewed 190 children with brucellosis admitted over a 7.8-year period. Seventy of these had articular involvement (36%) and the most common site was the hip (18%). All but one patient had unilateral infection. The hip was the only joint infected in 20 patients (57%). The next most common articular site was the knee. All patients had painful limitation of movement and this was the only articular sign in 28 (80%). Extra-articular signs included fever and hepatosplenomegaly. Brucella infection should be considered in every child from an endemic area who presents with fever and joint symptoms. The insidious onset and a normal or low leucocyte count help the differentiation from acute septic arthritis. Children with hip involvement had a slower response to treatment, longer hospital stays and a higher incidence of complications and relapse than those without. Complications included dislocation (n = 4) and avascular necrosis of the femoral head (n = 1). Treatment by combination chemotherapy for 6 to 12 weeks usually achieves cure and prevents relapse. A multidisciplinary team approach to management is recommended.
King Saud University, Abha, Saudi Arabia.
B
B
Benjamin
M R
MR
Khan
D001170:Arthritis, Infectious / Q000175:diagnosis*; D002006:Brucellosis / Q000175:diagnosis*; D002675:Child, Preschool; D005260:Female; D006621:Hip Joint; D006801:Humans; D007223:Infant; D008297:Male