Tian Yuan, Yang Xuying, Yang Ying, Lin Tianwei, Wang Guoxia, Zhang Ye, Wu Haibin, Wang Juan
Department of Surgical Intensive Care Unit, Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an, 710300, Shaanxi, China.
Department of Scientific Affairs, Hugobiotech Co., Ltd, Beijing, 102600, China.
Open Life Sci. 2025 Mar 28;20(1):20221042. doi: 10.1515/biol-2022-1042. eCollection 2025.
Septic arthritis of the hip (SAH) is a prevalent form of infectious arthritis in children that can lead to serious complications if not promptly diagnosed and treated. A 6-year 4-month-old female child with a 1-year history of acute lymphoblastic leukemia chemotherapy was admitted to our hospital due to a 1-day fever. After 1 week, the child experienced right inguinal pain and exhibited severe restriction in the flexion of the right lower limb and hip. Consequently, edema was observed in the right lower extremity and foot. SAH was initially diagnosed using computed tomography and magnetic resonance imaging examinations of both hip joints. Subsequently, incision and irrigation procedure were performed on the hip joint. Following the surgery, pus metagenomic next-generation sequencing (mNGS) were conducted promptly, and the mNGS analysis indicated an infection. The diagnosis of SAH was subsequently confirmed through polymerase chain reaction. The child's condition was successfully treated with a combination of amikacin and imipenem-cilastatin, leading to improvement and subsequent discharge in a satisfactory state. SAH caused by is a rare occurrence, and the utilization of mNGS holds significant potential for the early detection of uncommon infections in immunosuppressed children.
髋关节化脓性关节炎（SAH）是儿童感染性关节炎的一种常见形式，如果不及时诊断和治疗，可能会导致严重并发症。一名6岁4个月大的女童，有1年急性淋巴细胞白血病化疗史，因发热1天入住我院。1周后，患儿出现右腹股沟疼痛，右下肢和髋关节屈曲严重受限。随后，右下肢和足部出现水肿。最初通过对双髋关节进行计算机断层扫描和磁共振成像检查诊断为SAH。随后，对髋关节进行了切开冲洗手术。术后立即进行了脓液宏基因组下一代测序（mNGS），mNGS分析显示存在感染。随后通过聚合酶链反应确诊为SAH。患儿联合使用阿米卡星和亚胺培南-西司他丁成功治疗，病情好转，随后顺利出院。由[此处原文缺失病原体名称]引起的SAH很少见，mNGS在免疫抑制儿童罕见感染的早期检测中具有巨大潜力。
