Septic polyarthritis due to an infected nail bed around an ingrown toenail in a previously healthy boy
Veneman, N.G.P.; Waalkens, H.J.; van Raaij, J.J.A.M.; Brouwer, R.W.
Nederlands Tijdschrift Voor Geneeskunde 150(17): 973-976
2006
ISSN/ISBN: 0028-2162 PMID: 17225739 Document Number: 605029
A 17-year-old, previously healthy boy was admitted with complaints of fever, malaise and pain in the pubic region and groin. His left elbow was also warm and swollen and could not be extended fully. Cultures of fluid drained from both hips and the elbow, blood and inflamed tissue from the nail bed of the right big toe yielded Staphylococcus aureus. The patient was treated with intravenous antibiotics for septic arthritis of both hips, the left elbow and possibly the pubic symphysis. The infected nail bed, which was the most likely port of entry, was also treated. One year later, the original painful symptoms had disappeared but the right hip was almost immobile. In a patient with indications of septic arthritis, timely diagnosis and adequate therapy reduce the risk of permanent damage to the joint.