J. Paediatr. Child Health (1992) 28, 402-403

Cifrobacfer freundii sept ic a rt h rit is C.L. BRUEHL and R. LISTERNICK Department of Pediatrics, Division of General Academic and Emergency Pediatrics, The Children's Memorial Hospital, North western University Medical School, Chicago, Illinois, USA

Abstract Septic arthritis in an 8 month old infant due to Citrobacter freundii was treated successfully with a third generation cephalosporin. Infections due to Citrobacter are uncommon in this age group and are almost unknown as a cause of septic arthritis. Key words:

Citrobacter; septic arthritis

Septic arthritis IS a leading cause of severe mono-articular joint pain in children The joints involved most frequently are the knee, hip and ankle; joints of the upper extremity are affected less commonly. Unlike adults, the clinical presentation in young children can vary significantly. The most commonly isolated pathogens in young children are Staphylococcus aureus and Haemophilusinfluenzae.This report describes septic arthritis in an 8 month old infant caused by Citrobacter freundii, an organism infrequently associated with serious infections in infants and children.

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CASE REPORT An 8 month old female presented to the Emergency Department with limitation of movement of her right elbow for 2 days. Although the parents thought that she had injured her arm, there was no history of trauma. The child would reach for objects but would not completely flex or extend her elbow. There was no history of fever, cough, vomiting or diarrhoea. She had taken one dose of an unknown medicine 1 day prior to presentation. On physical examination, she appeared healthy. Her rectal temperature was 38.6"C; all other vital signs were normal. Her weight was within normal limits for her age. Abnormal findings were limited to the right elbow. The right arm was maintained rigidly with approximately 30" of flexion at the elbow. There was a small joint effusion; the overlying skin was warm but not erythematous. Attempts at flexion or extension of the joint produced severe discomfort. Radiologic examination of the joint and surrounding structures revealed no fracture, dislocation or soft tissue swelling. The white blood cell count was 20800/mm3 with a differential of 33Yo granulocytes,8% band forms, 1% eosinophils, 52% lymphocytes and 6% monocytes. The erythrocyte sedimentation rate was 54 (normal

Citrobacter freundii septic arthritis.

Septic arthritis in an 8 month old infant due to Citrobacter freundii was treated successfully with a third generation cephalosporin. Infections due t...
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