Abstract
We report a case of septic arthritis of the hip caused by toxigenic Corynebacterium diphtheria in a healthy, immunized child.
A four-year-old boy was admitted to our hospital with a four-day history of right thigh pain, inability to bear weight on the right leg and sore throat of one-day duration.
He was born in New Zealand and had been immunized against diphtheria. On admission he was febrile (37.3°C) with a congested throat. The right hip was flexed and externally rotated. His inflammatory markers were elevated. Aspiration of the hip yielded 8ml of yellow turbid fluid. Gram stain showed gram-positive bacilli. An arthrotomy was performed and the hip drained
Cultures of the aspirate grew Corynebacterium diphtheriae, the toxigenicity confirmed by the national reference laboratory.
The patient was treated with intravenous and oral antibiotics for 6 weeks and he made a full recovery.
Our patient had a history of immunization to diphtheria and this induces a protective level of antibodies against the toxin but does not prevent the bacteria from invading the blood stream and causing infection.
This is to our knowledge the first reported case of septic arthritis caused by toxigenic strain of Corynebacterium diphtheria.
The abstracts were prepared by Jean-Claude Theis. Correspondence should be addressed to him at Department of Orthopaedic Surgery, Dunedin Hospital, Private Bag 1921, Dunedin, New Zealand.
