Septic arthritis (being treated with antibiotics)

Advice for parents / carers taking their child home after seeing a hospital-based healthcare professional.

Septic arthritis is a bacterial infection in a joint (the connection made between bones in the body). It can occur at any age and in any joint.

Symptoms
  • Pain or discomfort on touching and / or moving the joint
  •  Limping or inability to bear weight on the affected limb
  • Swelling and / or redness of the affected area may occur
  • Fever may be present
Causes

 Septic arthritis often happens after a recent injury or infection, such as a cough or cold. Bacteria travel through the bloodstream and enter the joint area. Pus (fluid from the inflamed area) can form and cause swelling and pain.

When to seek further help:

If your child has any of the following:

  • Becomes pale, mottled and feels abnormally cold to touch
  • Has blue lips
  • Severe breathing difficulty - too breathless to talk / eat or drink
  • Has a fit / seizure
  • Becomes extremely agitated, confused or very lethargic (difficult to wake)

You need urgent help

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Increase in pain, swelling, redness, stiffness, and warmth in the affected area.
  • Is finding it hard to breathe
  • Seems dehydrated (sunken eyes, drowsy or no urine passed for 12 hours)
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
  • Has extreme shivering or complains of muscle pain
  • Has had chickenpox in the past few days and is now getting more unwell with a high fever and spreading red rash
  • Swelling of a limb or joint
  • Too painful for your child to stand
  • Has a swollen eye
  • Continues to have a fever of 38.0°C or above for more than 5 days
  • Is getting worse or if you are worried

 

You need to contact the discharging ward urgently

  • If none of the above features are present

Self Care

Continue providing your child’s care at home using the advice below. If you are still concerned about your child, speak to your health visitorlocal pharmacist or call NHS 111– dial 111. Keep monitoring your child for red and amber features and seek help if they develop

Treatment

 We can treat septic arthritis and relieve the pain with an operation to drain the infected fluid from the joint. For the operation, your child will be given a general anaesthetic (medicine that puts you to sleep during the procedure). After the operation, they will need to rest affected joint to help it to heal. We may use a plaster cast or skin traction, depending on which joint has been affected. If it is the hip joint, we may use a hip spica (a type of plaster cast).

We will give your child antibiotic therapy (medicine that fights infection) directly into the bloodstream (intravenous) via a cannula (a small plastic tube). We will take blood tests and help your child’s doctor prescribe the right antibiotics to treat the infection.

The team caring for your child will decide how long they need to have this treatment and when to change from intravenous to oral antibiotics (tablets or liquid). This will depend on how quickly your child responds to the treatment and whether they have other health conditions. Antibiotics are usually given for a total of two to three weeks.

You can give your child regular pain relief (such as paracetamol or ibuprofen) until their discomfort has improved.

What else can you do to help?

It is very important to make sure your child takes every dose of their oral antibiotics.so that they recover from the infection and prevent it coming back. You can give regular pain relief (paracetamol or ibuprofen) until the pain has improved. Please note:  ibuprofen should not be used if your child has chicken pox.

Complications

 Septic arthritis usually clears up completely when a child has treatment for it, and children do not usually experience long-term complications. The orthopaedic team will review your child to monitor their progress.

If you are concerned that your child’s condition is getting worse (see table above), you should contact the hospital urgently – you’ll find the contact details on the information you were provided with when your child was discharged.

CALL 999 FOR AN AMBULANCE IF YOU ARE SERIOUSLY CONCERNED FOR YOUR CHILD.                                                                                                        

Preventing septic arthritis reoccuring

 Make sure your child takes their entire course of antibiotics as directed by their health care professional. Your child will also have follow-up appointments after they leave hospital. It is important to keep these appointments, even if your child seems well, to make sure that there has not been any damage to the joint.

For further information on helping to keep your child healthy, click here.

 

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