Septic hip in a child.

Septic arthritis of the hip is uncommon in the school-age child. Presenting signs may be subtle and consequently may delay the diagnosis. This case report deals with a ten-year-old child who presented with an eight-day history of pain in the inner thigh associated with decreased range of motion of her hip, fever, and an inability to bear weight. Radiographic findings included demineralization of the femoral head. Initial laboratory findings showed leukocytosis and a sharply elevated Westergren sedimentation rate. Joint fluid Gram stain showed gram-positive cocci. Blood culture and joint culture grew Staphylococcus aureus. Therapy involved immediate operative drainage of purulent joint fluid, immobilization of the joint, and intravenous antibiotic therapy. Initial antibiotics were chosen based on synovial fluid Gram stain and the age of the patient. During therapy with antistaphylococcal penicillin, the patient developed a drug induced neutropenia.