Ιnflammatory or septic arthritis associated with mycoplasma pneumonia in children: Two case reports and review of the literature.

Abstract

Inflammatory or septic arthritis due to Mp is an extremely unusual manifestation in children, and the functional outcome of the joints is difficult to be predicted. Two cases with Mp infection are presented. The first patient had positive PCR for Mp after hip aspiration and arthrotomy with thorough irrigation and debridement. A flattened femoral head was detected during the follow-up, which became quite spherical a year after. An arthrotomy with medial synovectomy of the knee was performed in the second patient. Lack of full knee extension was presented during the first 3months, which gradually decreased to 7° in the final follow-up. The suspicion of Mp infection with extra-pulmonary involvement in children is mainly based on clinical, epidemiological and radiological data, but laboratory testing is required for confirmation. Rapid diagnosis of probability consists of serum tests, and their results are essential for early therapeutic planning. The direct diagnosis of Mp DNA through polymerase chain reaction (PCR) provides specificity and sensitivity. Very few cases of arthritis associated with Mp infection have been published but not with the severity of our cases. Clinical suspicion of Mp infection is of great importance, and the outcome depends on early diagnosis and specific treatment.