Brachial plexus neuropathy secondary to septic arthritis and osteomyelitis: report of two cases
Wang, Y.C.; Lin, F.K.; Hung, K.L.; Wu, D.Y.
Zhonghua Minguo Xiao Er Ke Yi Xue Hui Za Zhi Zhonghua Minguo Xiao Er Ke Yi Xue Hui 35(5): 449-454
1994
ISSN/ISBN: 0001-6578 PMID: 7942033 Document Number: 434104
Two infants, delivered uneventfully, later developed right brachial plexus palsy secondary to pyogenic osteomyelitis and arthritis of the right shoulder joint. Weakness of right arms occurred at the sixth and tenth days of age respectively. Both had right arm tenderness on palpation and passive movement. Roentgenograms of their right shoulder joints showed irregular radiolucency of the proximal margin of right humerus head. In both cases, electromyography revealed various degrees of significant denervation pattern for the C5-C7 innervated muscles. Pus culture from right shoulder joints grew Streptococcus viridans and Staphylococcus aureus, respectively. After antibiotic therapy and arthrotomy with drainage, weakness improved gradually following continuous rehabilitation. Follow-up at six months of age showed almost complete recovery of right upper extremity function in one patient, but mild residual weakness in the other. Follow-up electromyography studies showed continued improvement. The possible mechanism of this rare occurrence is discussed.