Abstract
A 9-year-old boy presented with high-grade fever associated with pain and swelling in right hip and left leg of 1-week duration. Pus was found on diagnostic aspiration of the right hip joint. Emergency arthrotomy was performed through anterior approach with drill holes in proximal femur and culture showed MRSA. Intravenous antibiotics were given for 4 weeks. Patient symptomatically improved in immediate postoperative period and in bed hip mobilization was started. On eighth postoperative day, child developed high-grade intermittent fever with chills and rigors and diagnosed as plasmodium falciparum malaria. Fever subsided with antimalarial treatment. On twenty-first day, patient complained pain in right hip and X-ray showed posterior hip dislocation with osteomyelitis of proximal femur. Closed reduction and hip spica application was done under general anesthesia. At follow-up, the clinical result was fair with resolution of infection and stiff hip.
Abbreviations
- MRSA:
-
Methicillin-resistant Staphylococcal aureus
- ESR:
-
Erythrocyte sedimentation rate
- CRP:
-
C-reactive protein
References
Gillespie WJ, Nade SML (1987) Musculoskeletal infections. Blackwell Scientific, Melbourne, pp 27–28
Bennett OM, Namnyak SS (1992) Acute septic arthritis of the hipjoint in infancy and childhood. Clin Orthop 281:123–132
Khachatourians AG, Patzakis MJ, Roidis N et al (2003) Laboratory monitoring in pediatric acute osteomyelitis and septic arthritis. Clin Orthop 409:186–194
Perlman MH, Patzakis MJ, Kumar PJ et al (2000) The incidence of joint involvement with adjacent osteomyelitis in pediatric patients. J Pediatr Orthop 20:40–43
Wang C, Wang S, Yang Y, Tsai C, Liu C (2003) Septic arthritis in children: relationship of causative pathogens, complications, and outcome. J Microbiol Immunol Infect (China) 36:41–46
Herring JA (2002) Bone and joint infections. In: Herring JA (ed) Tachdjian’s pediatric orthopaedics, 3rd edn. Saunders, Philadelphia, PA, pp 1841–1877
Gwynne-Jones DP, Stott NS (1999) Community-acquired methicillin-resistant Staphylococcus aureus: a cause of musculoskeletal sepsis in children. J Pediatr Orthop 19:413–416
Martinez-Aguilar G, Hammerman WA, Mason EO Jr (2003) Clindamycin treatment of invasive infections caused by community-acquired, methicillin-resistant and methicillin-susceptible Staphylococcus aureus in children. Pediatr Infect Dis J 22:593–598
Hua KS, Huang YY, Shen DL, Chang IL, Chen SJ (2009) Septic hip dislocation in a child. Int Surg 94(2):115–118
Kim A, Palmieri TL, Greenhalgh DG, O’Mara MS (2006) Septic hip presenting with dislocation as a source of occult infection in a burn patient. J Burn Care Res 27(5):749–752
Conflict of interest
No funds were received in support of this study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sreenivas, T., Menon, J. & Nataraj, A.R. Late septic hip dislocation with multifocal osteomyelitis and malaria: a case report. Eur J Orthop Surg Traumatol 22, 717–720 (2012). https://doi.org/10.1007/s00590-011-0804-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00590-011-0804-z