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Elbow septic arthritis in an infant: an unusual presentation of invasive pneumococcal disease
  1. Paula Santos1,
  2. Catarina Gouveia2,
  3. Joana Ovídio3 and
  4. Catarina Ribeiro1
  1. 1Pediatrics, Centro Hospitalar do Médio Tejo, Hospital Rainha Santa Isabel, Torres Novas, Portugal
  2. 2Pediatrics, Centro Hospitalar de Lisboa Central, Hospital Dona Estefania, Lisboa, Portugal
  3. 3Pediatric Orthopedics, Centro Hospitalar de Lisboa Central, Hospital Dona Estefania, Lisboa, Portugal
  1. Correspondence to Dr Paula Santos; paula.sofia89{at}


Acute septic arthritis is a rare, potentially severe infection that requires immediate treatment to avoid long-term morbidity. Most common aetiological agents are commonly used for empirical treatment, but the choice of antibiotics may be influenced by other factors, such as the patient’s age and the epidemiological context.

We report an infant with elbow arthritis, whose treatment was changed after Streptococcus pneumoniae serotype 9N was isolated in the blood and synovial fluid. The child underwent arthrocentesis and received intravenous ampicillin followed by oral amoxicillin, with a favourable response and no sequelae at 1-year follow-up.

We report an uncommon manifestation of invasive pneumococcal disease in a young immunised healthy infant caused by a non-vaccine serotype. The presence of S. pneumoniae should be considered in joint infections, especially in infants and those with a history of respiratory symptoms.

  • Infections
  • Paediatrics (drugs and medicines)
  • Bone and joint infections
  • Vaccination/immunisation

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: PSPdS, JO, CG, CR. The following authors gave final approval of the manuscript: JO, CG, CR.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.