An 18-month-old woman who was taken to the emergency department complaining of a 48-hour history of fever of 38'5o C maximum axillary, lameness, passive pain and active limitation of the left hip.
A blood analysis was performed showing an increase in acute phase reactants (17,800 leukocytes with 53% neutrophils, 433,000 platelets, germ ESR 55 mm/hour, CRP 9'56 mg/dL and intra-articular PCT 1'5 ng/mL).
The suspicion of septic arthritis of the left hip was decided to perform arthrocentesis in which a purulent synovial fluid was obtained.
The synovial fluid is sent for biochemistry and culture and empirical parenteral antibiotic therapy is initiated with cefoxime positive for Haemophilus cloxacillin 180 mg/kg and 80 mg/kg. Synovial fluid culture results are compatible with septic arthritis
To determine a possible failure, as the patient was correctly vaccinated for vaccination, she was sent to the reference hospital to typify the bacteria, which turned out to be type f sensitive to cefuroxime age.
After one week of hospitalization, blood count, white blood cell count and immunoglobulin levels were normal.
The results of the culture and antibiogram were suspended with intravenous cloxacillin and continued with parenteral cefoxime alone at the same initial doses and monitoring of the clinical course.
After 10 days of intravenous antibiotic therapy and 14 days of oral antibiotic therapy (with amoxicillin-clavulanic acid), the evolution has been satisfactory (complete non-painful mobility, without lameness in the image and without sequelae).
The patient remains asymptomatic and without sequelae at 9 months of follow-up.
