Epidemiological and clinical profiles of septic arthritis in children of 0-2 years of age in Eastern Uttar Pradesh, India

Ekbal Ahmad; Priyanka Singh; Pawan Pradhan; Vijay Kumar Singh; Bhoopendra Sharma

doi:10.18203/2349-3291.ijcp20241360

Authors

Ekbal Ahmad Department of Pediatrics, Maharshi Devraha Baba Autonomous State Medical College, Deoria, Uttar Pradesh
Priyanka Singh Department of Pediatrics, B. R. D. Medical College, Gorakhpur, Uttar Pradesh, India
Pawan Pradhan Department of Orthopaedics, B. R. D. Medical College, Gorakhpur, Uttar Pradesh, India
Vijay Kumar Singh Department of Pediatrics, B. R. D. Medical College, Gorakhpur, Uttar Pradesh, India
Bhoopendra Sharma Department of Pediatrics, B. R. D. Medical College, Gorakhpur, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20241360

Keywords:

Septic arthritis, Mono-articular involvement, Synovial fluid

Abstract

Background: Septic arthritis identified as infectious arthritis is a serious joint infection following the invasion of joint cavities by infectious agents usually bacteria. Due to speediness of joint destruction untreated septic arthritis may result in morbidity and mortality.

Methods: Out of 71 sick children attending pediatric OPD/IPD of BRDMC Gorakhpur with musculoskeletal infection during November 2019 to October 2020, 52 patients of 0-2 years of age were enrolled for study. The computerized charts containing various parameters related to the epidemiological and clinical profiles of the patients were recorded and analyzed following statistical package for the social sciences (SPSS) version 23.

Results: Out of 52 children 28.8% were neonates under the age of 28 days, 73.1% were full-term infants and 23.1% were premature. Likewise, 17.3% of the cases were with low birth weight whereas 7.7% had a history of septic infection. Hip joints in 65.4%, knee joints in 23.1% and elbow and shoulder joints in 5.8% of patients were infected. 44.2% of cases had right side involvement, 36.5% left side, 19.2% e bilateral joints, 80.8% Mono-articular and 19.2% showed poly-articular involvement. 84.6% of cases showed joint pain whereas 92.3% showed joint swelling. In 20% patients microbial culture of joint fluid revealed the growth of Staphylococcus aureus, Candida spp, E. coli and Pseudomonas spp. In 78.8% cases no growth of any pathogen was recorded in their blood culture. Ultrasonography (USG) diagnosis revealed fluid collection at joints in 94.2% cases while 5.8% exhibited pus collection.

Conclusions: Septic arthritis was more common in males than females, monoarticular involvement was more common on the right side, hip joints were most affected joints and Staphylococcus aureus was the most common pathogen affecting the patients.

Metrics

Metrics Loading ...

References

Narang A, Mukhopadhyay K, Kumar P, Bhakoo ON. Bone and joint infection in neonates. Indian J Pediatr. 1998;65:461-4.

Alhaji MA, Mamuda A, Bello B, Usman MI, Muhammad S. Pattern of septic arthritis in a tertiary hospital in Northern Nigeria: A retrospective study. Afr J Med Health Sci. 2016;15:36-40.

Faust SN, Clark J, Pallett A. Managing bone and joint infection in children. Arch Dis Child. 2012;97:545-53.

Dodwell ER. Osteomyelitis and septic arthritis in children: current concepts. Curr Opin Pediatr. 2013;25:58-63.

Montgomery NI, Epps HR. Pediatric septic arthritis. Orthop Clin North Am. 2017;48(2):209-16.

Rai A, Chakladar D, Bhowmik S, Mondal T, Nandy A, Maji B, et al. Neonatal septic arthritis: Indian perspective. Eur J Rheumatol. 2019;19052.

Rudraprasad MS, Bhasme AS, Rajappa K, Srivastava A and Syed TG. Fungal septic arthritis in neonates: Is there an etiological shift? Int J Orthop Sci. 2020;6(3):214-7.

Kim J, Lee MU, Kim T. Nationwide epidemiologic study for pediatric osteomyelitis and septic arthritis in South Korea. Medicine. 2019;98(17):15355.

Smith RL, Schurman DJ, Kajiyama G, Mell M, Gilkerson E. The effect of antibiotics on the destruction of cartilage in experimental infectious arthritis. J Bone Jt Surg. 1987;69(7):1063-8.

Yadav S, Dhillon MS, Aggrawal S, Tripathy SK. Microorganisms and Their Sensitivity Pattern in Septic Arthritis of North Indian Children: A Prospective Study from Tertiary Care Level Hospital. Hindawi Publishing Corporation ISRN Orthopedics 2013;2013:583013.

Hadler NM, Johnson AM, Spitznajel JK, Quiinet RJ. Protease inhibitors in inflammatory synovial effusions. Ann Rheum Dis. 1981;40:55-60.

Al Saadi MM, Al Zamil FA, Bokhary NA, Al Shamsan LA, Al Alola SA, Al Eissa YS. Acute septic arthritis in children. Pediatr Int. 2009;51(3):377-80.

Mue DD, Salihu MN, Awonusi FO, Yongu WT, Kortor JN, Elachi IC. The epidemiology and outcome of acute septic arthritis: a hospital- based study. J West Afr Coll Surgeons. 2013;3(1):40-52.

Cohen E, Katz T, Rahamim E, Bulkowstein S, Weisel Y, Leibovitz R. Septic arthritis in children: Updated epidemiologic, microbiologic, clinical and therapeutic correlations. Pediatrics Neonatol. 2020;61:325-30.

Bono KT, Samora JB, Klingele KE. Septic Arthritis in Infants Younger Than 3 Months: A Retrospective Review. Orthopedics. 2015;38(9):787-93.

Issa S. Acute septic arthritis. Sudan Med J. 2001;39:33-5.

Pääkkönen M, Peltola H. Management of a child with suspected acute septic arthritis. Arch Dis Child. 2012;97:287-92.

Agarwal A, Aggarwal AN. Bone and Joint Infections in Children: Septic Arthritis. Indian J Pediatr. 2016;83(8):825-33.

Kang SN, Sanghera T, Mangwani J. The management of septic arthritis in children: systematic review of the English language literature. J Bone Joint Surg Br. 2009;91(9):1127-33.

Plumb J, Mallin M, Bolte RG. The role of ultrasound in the emergency department evaluation of the acutely painful pediatric hip. Pediatr Emerg Care. 2015;31:54-8.