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Septic arthritis in children: diagnosis and treatment

Authors Pääkkönen M

Received 29 January 2017

Accepted for publication 3 April 2017

Published 18 May 2017 Volume 2017:8 Pages 65—68

DOI https://doi.org/10.2147/PHMT.S115429

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Roosy Aulakh


Markus Pääkkönen1,2

1Department of Pediatric Orthopaedic Surgery, 2Department of Hand Surgery, Turku University Hospital and the University of Turku, Turku, Finland

Abstract: Acute septic arthritis in children is usually hematogenous. It is more common in boys, and it most often affects the large joints of the lower limb. Diagnosis is based on cultures obtained from the infected joint and is supported by C-reactive protein blood test or ultrasound imaging. Staphylococcus aureus is the most common causative agent and is the primary target for empiric treatment. First-generation cephalosporins and clindamycin are suitable antibiotics. Vancomycin is utilized in areas with high rates of clindamycin- and methicillin-resistant S. aureus. After a short intravenous administration of 2–4 days, a total course of 2 weeks is sufficient in uncomplicated cases. Early antibiotic treatment has significantly improved the prognosis in high-income settings, but uncomplicated recovery is compromised if the treatment is delayed. Complications such as symptomatic osteoarthritis or avascular necrosis of the femoral head develop slowly. A long follow-up of 1–2 years is required to detect all possible sequelae.

Keywords: child, septic arthritis, sepsis, Staphylococcus aureus

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