title: Septic arthritis in children in resource limited and non-resource limited countries: an update on diagnosis and treatment.
abstract: Septic arthritis (SA) is an orthopedic emergency in childhood. It is uncommon in high resource settings. However, an incidence of 5-20 per 100,000 children has been reported in low-income countries. Area covered: The predictive value of serum markers is still under debate and the proposed diagnostic algorithms for SA are not sufficiently validated in children. Recent data suggest that short-course intravenous treatment, followed by oral therapy, is as effective as traditional long-term treatment. Results from three randomized controlled trials suggest that the addition of systemic steroids may accelerate clinical improvement. Minimally invasive surgical techniques have been proposed for treatment in recent years. Expert commentary: The causes and the epidemiology of septic arthritis will continue to mutate according to the changes in immunization practices, bacterial resistance patterns and the implementation of PCR techniques. Future research should focus on the assessment of appropriate antibiotic regimens and surgical procedures.
authors.affiliation: a Pediatric Infectious Disease Unit , Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Chiappini
authors.affiliation: a Pediatric Infectious Disease Unit , Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: Maria Vincenza
authors.initials: MV
authors.lastname: Mastrolia
authors.affiliation: a Pediatric Infectious Disease Unit , Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Galli
authors.affiliation: b Meyer Health Campus , Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: De Martino
authors.affiliation: c Orthopaedics and Traumatology Department , Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Lazzeri
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D002648:Child; D019049:Developed Countries; D003906:Developing Countries; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D019637:Orthopedic Procedures / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; D005938:Glucocorticoids
keywords: Septic arthritis; antibiotic therapy; arthroscopy; arthrotomy; children; diagnosis; imaging techniques; joint aspiration