title: [Septic arthritis in two young children caused by unusual gram-negative pathogens].
abstract: Two children, a girl aged 2 years and a boy aged 10 months, were moderately ill with signs of inflammation of the left and the right knee, respectively. Both had had pharyngitis, and the boy also had paronychia of the right foot. The Gram preparation of synovial fluid showed Gram-positive cocci in the girl, while Kingella kingae was cultured. In the boy, a Moraxella was cultured from the synovial fluid using an aerobic blood culture system. Both recovered without sequelae after adequate antibiotic treatment. The micro-organisms cultured were Gram-negative bacteria, which are rarely seen in septic arthritis and are difficult to demonstrate. In young children, septic arthritis often presents with mild symptoms and inconclusive laboratory findings. Even if the Gram preparation of the synovial fluid shows no micro-organisms, unusual pathogens may be isolated by means of an aerobic blood culture system.
authors.affiliation: Afd. Kindergeneeskunde, Ziekenhuis Rijnstate, TA Arnhem.
authors.forename: J
authors.initials: J
authors.lastname: Bruijn
authors.forename: J
authors.initials: J
authors.lastname: Verhage
authors.forename: R W
authors.initials: RW
authors.lastname: Bosboom
authors.forename: F
authors.initials: F
authors.lastname: Brus
mesh_terms: D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000382:microbiology*; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology*; D006801:Humans; D007223:Infant; D017882:Kingella kingae / Q000302:isolation & purification*; D008297:Male; D009016:Moraxella / Q000302:isolation & purification*; D013582:Synovial Fluid / Q000382:microbiology