Septic arthritis of the hip, an unreported complication of perforated appendicitis: A case report

Mahnoor Zia, Nima Maghami
International Journal of Surgery Case Reports 2020 June 11, 72: 281-284

INTRODUCTION: Progression of inflammation in acute appendicitis can lead to appendiceal perforation, which is associated with higher morbidity and mortality. Bacteremia due to a perforated appendicitis can lead to distal bacterial seeding, resulting in further complications.

PRESENTATION OF CASE: We present here a case of appendiceal perforation in a 32-year-old previously healthy male. Patient was conservatively managed with intravenous (IV) antibiotics and was discharged on hospitalization day-6. Prior to scheduled interval appendectomy, he developed right sided hip pain with decreased range of motion. Computed tomography (CT) scan with contrast showed right hip abscess and enlarged pelvic lymph nodes. Arthrocentesis yielded purulent fluid with leukocytosis (84.8 k/CMM) and neutrophilia (89%). Patient underwent emergent incision and drainage of the hip abscess followed with 42-days of IV antibiotics for septic arthritis.

CONCLUSION: This case presents a unique occurrence of a complication from appendiceal perforation in patients who are initially managed non-operatively. Clinicians should be mindful of rare complications associated with non-operative management of appendicitis.

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