Polyarticular septic arthritis in an 11-year-old child.
A child with polyarthritis is always a diagnostic challenge for the treating physician. Polyarthritis can be a clinical manifestation of diverse disease processes, and the differential diagnosis is understandably very broad. We present a case of polyarticular septic arthritis, which is osteomyelitis complicated, caused by Streptococcus pyogenes identified by 16S polymerase chain reaction (PCR) in a healthy child, with previous synovial fluid cultures negative. This case underlines the importance of early aggressive therapy and the role of PCR/16S ribosomal bacterial DNA amplification to detect the causative microorganisms in septic arthritis when cultures remain negative.
Paediatric Rheumatology Department, Great Ormond Street Hospital NHS Foundation Trust and UCL Institute of Child Health, London, UK, raquelpcmarques@gmail.com.
Raquel
R
Campanilho-Marques
Vas
V
Novelli
Paul A
PA
Brogan
Despina
D
Eleftheriou
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000188:drug therapy; D002443:Ceftriaxone / Q000627:therapeutic use; D002648:Child; D002981:Clindamycin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy; D013297:Streptococcus pyogenes / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents; D002981:Clindamycin; D002443:Ceftriaxone