Artrite settica dell’anca in epoca neonatale: una sfida diagnostica

[Autom. eng. transl.] INTRODUCTION: Septic arthritis of the hip is a rather rare condition in the pediatric age that can develop following haematogenous diffusion, adjacent site inflammatory extension and / or direct microbiological inoculation. CLINICAL CASE: We describe the case of a 6-day-old baby coming to our attention due to the sudden appearance of irritability and hypomotility of the lower limbs. Born at term, from eutocical childbirth, in normal-run pregnancy, with unknown vaginal swabs. Neonatal weight and normal Apgar index. Regular perinatal period; slight instability of the right hip due to the Ortolani-Barlow maneuver. At the first evaluation in PS the child appeared apyretic, lively and reactive, with vital parameters in the norm. The right hip appeared flexed, extra-rotated and painful due to passive and active mobilization. The blood count and the dosage of inflammation indexes were not negative and no fractures were seen in the lower limb X-ray. A broad-spectrum intravenous antibiotic therapy (with amikacin and ceftazidime) was initiated for the echography of the intra-articular effusion hips. The NMR, later performed, confirmed the presence of right coxite, with capsular involvement, and indicated an eco-guided drainage. Culture of synovial fluid revealed growth of S. epidermidis. In the following week there was a clear improvement in clinical conditions with concurrent ultrasound resolution of joint effusion. The antibiotic therapy was then continued at home for a total of 10 days in the absence of remote sequelae. CONCLUSIONS: Early diagnosis (based on Morrey criteria) and timely treatment (with antibiotics allows the resolution of septic arthritis in children.