Friday, September 14, 2007

A case of Septic Arthritis and Spontaneous Pneumothorax

A boy of 2 year 4 months presented with respiratory distress of 1 day, fever of high grade for 7 days and swelling of left shoulder and arm of 8 days

On examination, he was found in dyspnoea, left side of the chest full with restrictricted movement,vocul fremitus absent with shifting of the trachea and apex beat and breath sound and vocal resonance absent.

His left shoulder was found swelled, hot and tender which extended down to the arm.

His X-ray of the shows Pneumothorax of the Lt side with collaps of the lungs and shifting of the mediastinum. Xray of the left arm shows no bony pathology.

The case was labeled as Septic arthritis of the left shoulder and Spontaneous with Pheumothorax of both lungs.

Water seal drainage of the chest was given immediately after admission and later when the patient settled the pus was drained out from the left shoulder by giving incision. Inj Ceftriaxone and Inj flucloxacillin were given as antibiotics.

Interestingly the patient developed later pneumothorax of the rt side of the chest which was found on check x-rays.

Temporary relieve of the tension in the Rt chest was also required. Now the Patient is recovering and we hope to discharge the patient within few days.

Our surgical and orthopedic colleagues helped us in the management of the patient.


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