Pediatrics & Neonatology
Volume 50, Issue 1 , Pages 33-35, February 2009

Salmonella Septic Arthritis Involving Multiple Joints in a Girl with Acute Lymphoblastic Leukemia at Diagnosis

  • Wei-Chin Yang

      Affiliations

    • Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
    • ,
  • Yhu-Chering Huang

      Affiliations

    • Division of Infectious Diseases, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
    • ,
  • Ming-Horng Tsai

      Affiliations

    • Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
    • ,
  • Cheng-Hsun Chiu

      Affiliations

    • Division of Infectious Diseases, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
    • ,
  • Tang-Her Jaing

      Affiliations

    • Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
    • Corresponding Author InformationCorresponding author. Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Children's Hospital, 5 Fu-Shin Street, Kwei-Shan 333, Taoyuan, Taiwan

Received 14 February 2008; received in revised form 25 August 2008; accepted 1 December 2008.

Septic arthritis due to Salmonella has been reported frequently, but multiple joint involvements have rarely been reported in children. A 3-year-old girl presented with Salmonella arthritis involving multiple joints. Laboratory investigations revealed pancytopenia inconsistent with diagnosis of juvenile rheumatoid arthritis or septic arthritis. Bone marrow examination 2 weeks later confirmed the diagnosis of acute lymphoblastic leukemia (ALL). Immunophenotyping studies were consistent with a diagnosis of pre-B ALL. This case illustrates that a delay in the diagnosis may occur when there is an apparent infection focus without classic features of leukemia. Multiple joints involvement of septic arthritis associated with pancytopenia should highlight the possibility of underlying hematologic disorders.

Key Words:  acute lymphoblastic , leukemia , bone marrow , examination; , Salmonella , septic arthritis

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PII: S1875-9572(09)60027-9

doi:10.1016/S1875-9572(09)60027-9

Pediatrics & Neonatology
Volume 50, Issue 1 , Pages 33-35, February 2009

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