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JRPMS Vol 4, No 2, June 2020, p.38-43

doi: 10.22540/JRPMS-04-038

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Case Report

A case of hip joint septic arthritis as a complication of a prostate abscess

Themistoklis Vampertzis1, Eirini Iosifidou1, Christina Barmpagianni2, Dimitrios Takis1, Nikolaos Manidakis1, Georgios Zervopoulos3, Stergios Papastergiou1

  1. Department of Orthopedics, Unit for Sports Medicine, Agios Pavlos G.H.Th., Thessaloniki, Greece
  2. Trauma and Orthopaedics, Northwick Park Hospital, London North West University Health Care NHS Trust, UK
  3. Department of Urology, Agios Pavlos G.H.Th., Thessaloniki, Greece

Keywords: Diabetes mellitus, Hip arthroplasty, Hip joint, Prostate abscess, Septic arthritis


Abstract

Septic arthritis due to an infection elsewhere in the body is a dangerous disease manifestation. The elderly and particularly those with comorbidities such as diabetes mellitus, arterial hypertension; haemodialysed and the immunocompromised are more susceptible. Infections of the prostate can spread via the blood to cause sepsis and/or affect joints. Although prostatitis can be diagnosed based on common symptoms and tests, chronic infections and abscesses can be silent and asymptomatic, which allows them to spread. We present a case of a silent prostatic abscess which spread to the hip joint causing septic arthritis and joint destruction. This was further complicated by patient incompliance and refusal for an early surgical debridement. As a result, the condition was aggravated and the joint was lost. The important point made is that clinical presentation of septic arthritis is not always alarming. Moreover, care should be taken to recognise the origin of infection, as it can also be occult. Prompt diagnosis and early treatment are vital, as joint destruction is rapid. Additionally, treatment is complex, dangerous and expensive, with high doses of strong antibiotics, surgeries and variable results. Relapses are common in advanced cases and the hazard for progression to sepsis cannot be neglected.