CC BY-NC-ND 4.0 · AJP Rep 2021; 11(03): e123-e126
DOI: 10.1055/s-0041-1735633
Case Report

Newborn Septic Arthritis—A Rare Presentation of Late-Onset Group B Streptococcal Disease: Case Report and Short Review of the Literature

Rahel Schuler
1   Department of General Pediatrics and Neonatology, Justus Liebig University, Giessen, Germany
,
Harald Ehrhardt
1   Department of General Pediatrics and Neonatology, Justus Liebig University, Giessen, Germany
,
Klaus-Peter Zimmer
1   Department of General Pediatrics and Neonatology, Justus Liebig University, Giessen, Germany
,
Daniel Berthold
2   Department of Diagnostic and Interventional Radiology, University Hospital Giessen, Justus Liebig University, Giessen, Germany
,
Janina Trauth
3   Department of Medicine II, Section of Infectious Diseases, Justus Liebig University, Giessen, Germany
,
Christian Fölsch
4   Department of Orthopaedic Surgery, Justus-Liebig-University, Giessen, Germany
,
Markus Waitz
1   Department of General Pediatrics and Neonatology, Justus Liebig University, Giessen, Germany
› Author Affiliations

Abstract

Group B Streptococcus (GBS) disease is a leading cause of invasive bacterial infections among neonates. We present the case of an 11-day-old neonate with septic arthritis as a rare presentation of late-onset disease (LOD) with a favorable short-term outcome. GBS is a leading cause of neonatal infection. Early-onset disease (EOD) is defined as infection from birth to 6 days of age, while LOD occurs from 7 days to approximately 3 months of age. EOD is acquired through vertical transmission and can be reduced through application of intrapartum antibiotic prophylaxis (IAP). LOD can be acquired from the mother or from environmental sources, unlikely to be prevented by IAP. The most common presentation of EOD is bacteremia (83%), pneumonia (9%), and meningitis (7%). While the clinical picture in both EOD and LOD frequently resembles in LOD hamatogenous spreading may predispose neonates to present with uncommon organ manifestation other than the classic systemic signs of sepsis, for example, septic arthritis. Herein, we report on the management and outcome of a term neonate with late onset GqBS bacteremia and subtle clinical symptoms of septic monoarthritis.



Publication History

Received: 13 April 2021

Accepted: 10 May 2021

Article published online:
30 September 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Berardi A, Rossi C, Lugli L. et al; GBS Prevention Working Group, Emilia-Romagna. Group B streptococcus late-onset disease: 2003-2010. Pediatrics 2013; 131 (02) e361-e368
  • 2 Matsubara K, Hoshina K, Kondo M. et al. Group B streptococcal disease in infants in the first year of life: a nationwide surveillance study in Japan, 2011-2015. Infection 2017; 45 (04) 449-458
  • 3 Phares CR, Lynfield R, Farley MM. et al; Active Bacterial Core surveillance/Emerging Infections Program Network. Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005. JAMA 2008; 299 (17) 2056-2065
  • 4 Li Y, Zhou Q, Liu Y. et al. Delayed treatment of septic arthritis in the neonate: a review of 52 cases. Medicine (Baltimore) 2016; 95 (51) e5682
  • 5 Pittard III WB, Thullen JD, Fanaroff AA. Neonatal septic arthritis. J Pediatr 1976; 88 (4 pt 1): 621-624
  • 6 Sreenivas T, Nataraj AR, Kumar A, Menon J. Neonatal septic arthritis in a tertiary care hospital: a descriptive study. Eur J Orthop Surg Traumatol 2016; 26 (05) 477-481
  • 7 Umadevi S, Kali A, Sreenivasan S, Pramodhini S, Charles MV. Septic arthritis caused by group A Streptococcus in newborn: an unusual presentation. J Clin Diagn Res 2013; 7 (06) 1143-1144
  • 8 Offiah AC. Acute osteomyelitis, septic arthritis and discitis: differences between neonates and older children. Eur J Radiol 2006; 60 (02) 221-232
  • 9 McPherson DM. Osteomyelitis in the neonate. Neonatal Netw 2002; 21 (01) 9-22
  • 10 Castellazzi L, Mantero M, Esposito S. Update on the management of pediatric acute osteomyelitis and septic arthritis. Int J Mol Sci 2016; 17 (06) E855
  • 11 Kimberlin DW, Brady MT, Jackson MA. eds. Red Book: 2018–2021 Report of the Committee on Infectious Diseases. 31st ed.. Itasca, IL: American Academy of Pediatrics; 2018: 762
  • 12 Coon ER, Srivastava R, Stoddard G, Wilkes J, Pavia AT, Shah SS. Shortened IV antibiotic course for uncomplicated, late-onset group B streptococcal bacteremia. Pediatrics 2018; 142 (05) e20180345
  • 13 Peltola H, Pääkkönen M, Kallio P, Kallio MJ. Osteomyelitis-Septic Arthritis (OM-SA) Study Group. Prospective, randomized trial of 10 days versus 30 days of antimicrobial treatment, including a short-term course of parenteral therapy, for childhood septic arthritis. Clin Infect Dis 2009; 48 (09) 1201-1210
  • 14 Peltola H, Pääkkönen M, Kallio P, Kallio MJ. Osteomyelitis-Septic Arthritis Study Group. Short- versus long-term antimicrobial treatment for acute hematogenous osteomyelitis of childhood: prospective, randomized trial on 131 culture-positive cases. Pediatr Infect Dis J 2010; 29 (12) 1123-1128
  • 15 Keij FM, Kornelisse RF, Hartwig NG, Reiss IKM, Allegaert K, Tramper-Stranders GA. Oral antibiotics for neonatal infections: a systematic review and meta-analysis. J Antimicrob Chemother 2019; 74 (11) 3150-3161