Septic Arthritis of the Hip Complicating a Non-Perforated Acute Appendicitis - A Case Report and Review of the Literature.
5 affiliations
- 1Department of Orthopaedic Surgery, Thelle Mogoerane Regional Hospital, Vosloorus, South Africa.
- 2Department of Orthopaedic Surgery, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa.
- 3Gauteng Department of Health, Johannesburg, South Africa.
- 4Department of Orthopaedic Surgery, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa.
- 5Department of General Surgery, Thelle Mogoerane Regional Hospital, Vosloorus, South Africa.
Abstract
Septic arthritis is an orthopedic emergency, such that without prompt intervention, cartilage destruction, permanent disability, or death may occur. Although Salmonella Typhi is a common cause of enteric fever, its spread to the native hip joint in a healthy child, following non-perforated appendicitis, is exceptionally rare. We describe a unique case and review the literature to draw lessons for clinical practice. A previously healthy 13-year-old boy presented with 10 days of diarrhea, 7 days of abdominal pain and weakness, and difficulty mobilizing. Examination revealed fever, diffuse abdominal tenderness without peritonitis, and decreased range of motion of the left hip. Laboratory tests showed elevated septic markers. Abdominal ultrasound confirmed non-perforated appendicitis, which was treated via an emergency appendectomy. Persistent fever and left hip pain prompted an orthopedic consultation. A hip ultrasound demonstrated a complex effusion prompting an arthrotomy, which yielded purulent fluid culturing Salmonella Typhi. Despite culture-targeted antibiotics (ceftriaxone), persistently high inflammatory markers and computed tomography evidence of a complex collection around the hip warranted an additional debridement. Supportive care and physiotherapy yielded a good functional outcome at 2-week follow-up. This case highlights that even uncomplicated appendicitis can result in hematogenous spread of Salmonella Typhi to a distant joint in an immunocompetent child. Persisting signs of sepsis or new joint symptoms after abdominal surgery should prompt immediate imaging and an arthrotomy. Early diagnosis using clinical criteria, surgical re-intervention when needed, and coordinated multidisciplinary management are vital in preserving joint integrity and improving outcomes in such atypical presentations.
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BibTeX
@article{ogunbanjo2026septic,
title = {{Septic Arthritis of the Hip Complicating a Non-Perforated Acute Appendicitis - A Case Report and Review of the Literature.}},
author = {Olusegun Olugboyega Edang Ogunbanjo and Pontso Raphadu and Benedict Khoza and Leonard Muhango and Marule Paul Kgagudi},
journal = {Journal of orthopaedic case reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8464},
url = {https://europepmc.org/article/MED/42997043},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Septic Arthritis of the Hip Complicating a Non-Perforated Acute Appendicitis - A Case Report and Review of the Literature.
AU - Olusegun Olugboyega Edang Ogunbanjo
AU - Pontso Raphadu
AU - Benedict Khoza
AU - Leonard Muhango
AU - Marule Paul Kgagudi
PY - 2026
DA - 2026/11/01
JO - Journal of orthopaedic case reports
DO - 10.13107/jocr.2026.v16.i11.8464
UR - https://europepmc.org/article/MED/42997043
AB - Septic arthritis is an orthopedic emergency, such that without prompt intervention, cartilage destruction, permanent disability, or death may occur. Although Salmonella Typhi is a common cause of enteric fever, its spread to the native hip joint in a healthy child, following non-perforated appendicitis, is exceptionally rare. We describe a unique case and review the literature to draw lessons for clinical practice. A previously healthy 13-year-old boy presented with 10 days of diarrhea, 7 days of abdominal pain and weakness, and difficulty mobilizing. Examination revealed fever, diffuse abdominal tenderness without peritonitis, and decreased range of motion of the left hip. Laboratory tests showed elevated septic markers. Abdominal ultrasound confirmed non-perforated appendicitis, which was treated via an emergency appendectomy. Persistent fever and left hip pain prompted an orthopedic consultation. A hip ultrasound demonstrated a complex effusion prompting an arthrotomy, which yielded purulent fluid culturing Salmonella Typhi. Despite culture-targeted antibiotics (ceftriaxone), persistently high inflammatory markers and computed tomography evidence of a complex collection around the hip warranted an additional debridement. Supportive care and physiotherapy yielded a good functional outcome at 2-week follow-up. This case highlights that even uncomplicated appendicitis can result in hematogenous spread of Salmonella Typhi to a distant joint in an immunocompetent child. Persisting signs of sepsis or new joint symptoms after abdominal surgery should prompt immediate imaging and an arthrotomy. Early diagnosis using clinical criteria, surgical re-intervention when needed, and coordinated multidisciplinary management are vital in preserving joint integrity and improving outcomes in such atypical presentations.
SN - 2250-0685
SN - 2321-3817
ER -