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Slovenska pediatrija 2019; 26: 229-233

https://doi.org/

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Case report

KNEE PAIN IN A CHILD

Mihaela Slemnik
Oddelek za pediatrijo, Splošna bolnišnica Slovenj Gradec Gosposvetska cesta 1, 2380 Slovenj Gradec, Slovenija

Eva Miler Mojškerc
Oddelek za pediatrijo, Splošna bolnišnica Slovenj Gradec, Slovenj Gradec, Slovenija

Abstract

This article presents a case of a two-year-old boy with staph­ylococcal skin infection and cellulitis in the area above the left knee area, which clinically manifested as possible septic arthritis of the left knee. After diagnostic process we imme­diately started empiric antibiotic therapy with flucloxacil­lin. we performed imaging tests - ultrasound of the left knee with joint puncture and x-ray imaging of the knee, which showed changes in the distal epiphysis of the femur. To exclude osteomyelitis an MRI of the knee was performed. Normal MRI scans and sterile joint fluid excluded that diag­nosis. On the eight day of antistaphylococcal treatment, a rash appeared, clinically similar to a Microsporum canis infection after known contact with a kitten. with sudden onset of soft tissue infection and intense systemic inflamma­tory response after a cat scratch, infection with Pasteurella spp. has to be taken into account.

Key words: cellulitis, septic arthritis, osteomyelitis, anti-bac­terial agents, Staphylococcus aureus, Microsporum, Pasteurella