Study says Lyme disease and septic arthritis in children required different treatment
Septic or infectious arthritis of the knee and Lyme disease present similar symptoms in children but require different immediate treatment to ensure optimal recovery, a new study suggests.
The study, published in the Journal of Bone and Joint Surgery, has identified four symptoms that are predictive of septic arthritis when the condition presents itself in a child’s knee – an important distinction in areas where Lyme disease is prevalent.
Septic arthritis is considered a medical emergency that requires immediate treatment. Lyme disease is an infection common in the northwest and northeast parts of the US and is caused by bacteria normally found in deer and transmitted to people through ticks. It is treated by antibiotics. However, as well as knee swelling and pain, both conditions may cause fever, swelling of other joints and other similar symptoms.
For this new study, researchers reviewed the records of 189 patients under the age of 18 who presented to the Children’s Hospital of Philadelphia (CHPO) with excess fluid in the knee between 2005 and 2013. Of these patients, 23 had culture-positive septic arthritis; 26 had culture-negative septic arthritis; and 140 had Lyme disease.
The researchers found four characteristics that are predictive of factors for septic arthritis including knee pain, fever and aged younger than two years old.
“The probability of septic arthritis with any one factor present was 18 percent compared to 100 percent will all four factors present,” says study author Dr Wudbhav N. Sankar, an orthopaedic surgeon at Children’s Hospital of Philadelphia. “Our study offers a useful prediction algorithm to help distinguish septic arthritis from a knee effusion caused by Lyme disease in children.”
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