Assessment and therapeutic choice in septic arthritis of the hip in an intravenous drug abuser: case report at 14 years follow-up and review of literature

Clin Ter. 2017 Jan-Feb;168(1):e8-e13. doi: 10.7417/CT.2017.1975.

Abstract

Introduction: Osteoarticular infections are found frequently in drug addicted individuals, representing one of the main reasons for their hospitalization. Through inoculation, the pathogenic agents can enter the individual's system directly through the skin or parenterally, transmitted, that is, through syringes and other objects used during such practice. In these particular conditions, or when the medical history is vague, a warranted suspicion and the execution of targeted research can help in the diagnosis of high-risk patients such as addicts.

Discussion: With this paper, the Authors are presenting a case of septic arthritis in the hip joint, in a drug addicted patient with the habit of injecting narcotics into the femoral vein, in correspondence of the anatomical region known as the triangle of Scarpa. Following an examination of the bacterial culture samples taken by arthrocentesis, the S. Aureus infection was identified and a targeted antibiotic therapy (coxacillin and aminoglycosides) was prescribed. After one year, with clinical examination and medical scans resulting negative for infection, there was a remaining deformity of the femoral head and, therefore, a total hip arthroplasty (THA) was performed. The 14 year post-operative clinical examination and medical scan check-up showed a complete articular functionality and recovery of normal daily and work related activities.

Keywords: Heroin Addiction; Hip arthroplasty; Intravenous Drug abuser; Septic Hip Arthritis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Arthritis, Infectious / diagnosis*
  • Arthritis, Infectious / therapy
  • Arthroplasty, Replacement, Hip / methods
  • Drug Users*
  • Follow-Up Studies
  • Hip Joint
  • Humans
  • Male
  • Staphylococcus aureus / isolation & purification

Substances

  • Anti-Bacterial Agents