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Bacterial Spectrum Analysis of Pediatric Septic Arthritis in Sanglah General Hospital (2019-2021): A Case Series

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Journal of Clinical Orthopaedics | Vol 9 | Issue 1 |  January-June 2024 | page: 61-69 | Ida Bagus Anom Krishna Caitanya, Made Agus Maharjana, Nyoman Gede Grenata Nanda Ustriyana

DOI: https://doi.org/10.13107/jcorth.2024.v09i01.638

Author: Ida Bagus Anom Krishna Caitanya [1], Made Agus Maharjana [1], Nyoman Gede Grenata Nanda Ustriyana [1]

[1] Department of Orthopaedics and Traumatology, Faculty of Medicine Udayana University, Prof Ngoerah General Hospital, Denpasar, Indonesia

Address of Correspondence

Dr. Ida Bagus Anom Krishna Caitanya,
Department of Orthopaedics and Traumatology, Faculty of Medicine Udayana University, Prof Ngoerah General Hospital, Denpasar, Indonesia.
E-mail: borthopaedi@gmail.com

Abstract

This case series presents five pediatric patients diagnosed with septic arthritis in Sanglah General Hospital from 2019 to 2021. The most common infecting organism was Staphylococcus aureus, comprising 66.7% of all infections. Other organisms described in literatures are Salmonella, Staphylococcus epidermidis, Enterobacter cloacae, and Mycobacterium tuberculosis. Antibiotic treatment should be started as soon as the diagnosis is suspected and modified once the organism isolated from the synovial fluid (SF) has been characterized. Unfortunately, in many cases, despite a high clinical suspicion of SA, the diagnosis cannot be confirmed because the SF is sterile on bacterial culture. This may lead to difficulties in patient management. The case series also analyzed the possible causes of negative culture results. The data showed three cases with no pathogen organism detected, which can be turned to false negative that ruled out the infection cause of the arthritis. The study suggests that in the future, other techniques might prove useful in increasing the sensitivity of the detection of bacterial infection, such as Polymerase chain reaction and detection of antibodies against the teichoic acid staphylococcal cell wall component. The detection and identification of Kingela kingae in synovial fluid have improved significantly since the development of PCR. The specificity of these assays relies on the ability of the PCR to generate only the expected amplification product. The duration of the laboratory to process is also a factor that affects the result. The study concludes that early diagnosis and prompt treatment are crucial in achieving good functional outcomes in pediatric septic arthritis.
Keywords: septic arthritis, pediatric patients, bacterial spectrum, diagnosis, culture methods

References

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How to Cite this article: Caitanya IBAK, Maharjana MA, Ustriyana NGGN. Bacterial Spectrum Analysis of Pediatric Septic Arthritis in Sanglah General Hospital (2019-2021): A Case Series. Journal of Clinical Orthopaedics 2024;January-June:9(1):61-69.

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Acute Osteomyelitis and Septic Arthritis in Children – Current Concepts in Diagnosis and Management

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Vol 2 | Issue 2 |  July – Dec 2017 | Page 16- 24 | Chintan Doshi, Kailash Sarathy, Alaric Aroojis

Authors: Chintan Doshi [1], Kailash Sarathy [1], Alaric Aroojis [1]

[1] Dept of Paediatric Orthopaedics, Bai Jerbai Wadia Hospital for Children, Parel, Mumbai, India.

Address of Correspondence
Dr. Alaric Aroojis
Department Of Paediatric Orthopedics,
Bai Jerbai Wadia Hospital For Children,
Parel, Mumbai – 400012, Maharashtra, India
Email : aaroojis@gmail.com

Abstract

Acute osteomyelitis and septic arthritis are the most common cause of morbidity in childhood. These occur more commonly in children upto 5 years of age. The most common organism responsible is Staphylococcus aureus, however, many other organisms are also known to cause osteoarticular infections in children. These infective conditions demand a prompt diagnosis and management, as any delay can lead to joint destruction, instability, deformity and significant limb length discrepancy. Thus early diagnosis and prompt management are of importance to achieve optimal goals. The clinical presentation of a child with osteoarticular infection is typical; with presence of fever, swelling and inability to move the affected extremity. However, sometimes the typical clinical findings are missing. Therefore it is important to follow a specific clinical, laboratory and imaging work-up to reach a definitive diagnosis. Following appropriate diagnosis, the further management protocol should be followed, with appropriate choice and dose of antibiotics and surgical debridement as required. The aim of this review article is to discuss the current concepts in acute osteomyelitis and septic arthritis in children. This article discusses the recent literature on etiological organisms, pathophysiology, current trends in investigations and management of osteoarticular infections in children.
Keywords : Acute osteomyelitis, Septic arthritis, Osteoarticular Infection.

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How to Cite this article: Doshi C, Sarathy K, Aroojis A. Acute Osteomyelitis And Septic Arthritis In Children – Current Concepts In Diagnosis And Management. Journal of Clinical Orthopaedics July-Dec 2017; 2(2): 16-24

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