Hematogenous septic arthritis after second degree burn and rational use of antibiotics

Abstract

A 51-month-old female patient, who has meningomyelocele, presented with complaints of pain, fever, and inability to move her left leg from the hip while receiving antibiotic treatment after a localized second degree burn (9%). Physical findings, radiographic findings, and aspiration fluid from the hip joint were consistent with septic arthritis (SA). Methicillin-sensitive staphylococcus aureus growth was observed in wound culture, blood culture and synovial fluid culture sent after the operation. As the clinical condition of the patient with hematogenous spread was stable, treatment with ampicillin-sulbacsite was started. In burn patients, SA should be suspected in cases with fever and joint movement limitation, and it should be predicted that infections related to the burn may be pathogenic for SA. A rational antibiotic approach should be adopted in order to prevent resistance. Cases occurring after the development of large surface burns are available in the literature, and our case is the first pediatric case to develop septic arthritis after small surface area burn.