title: Streptococcal toxic shock syndrome presenting as septic knee arthritis in a 5-year-old child.
abstract: Group A streptococci, also known as Streptococcus pyogenes, is a common cause of infection in the pediatric population. Recently, the incidence of streptococcal toxic shock syndrome, a serious and often deadly manifestation of group A streptococci infection, has increased. Streptococcal toxic shock syndrome often presents with complaints of musculoskeletal pain, which frequently leads to early involvement of an orthopaedic surgeon. In this case report, we present a 5-year-old child who presented with a septic arthritis of the knee, whose final diagnosis was streptococcal toxic shock syndrome. A review of the literature and the aspects of this case report emphasize the emergent nature of streptococcal joint infections and the judicious use of orthopaedic intervention in such patients.
authors.affiliation: Division of Pediatric Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY 10003, USA.
authors.forename: Basil J
authors.initials: BJ
authors.lastname: Alwattar
authors.forename: Allan
authors.initials: A
authors.lastname: Strongwater
authors.forename: Debra A
authors.initials: DA
authors.lastname: Sala
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D001182:Arthroscopy / Q000379:methods; D002675:Child, Preschool; D003646:Debridement / Q000379:methods; D003937:Diagnosis, Differential; D004333:Drug Administration Routes; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007719:Knee Joint; D008279:Magnetic Resonance Imaging; D008297:Male; D012772:Shock, Septic / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013290:Streptococcal Infections / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D007507:Therapeutic Irrigation / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids