{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:10:03Z","timestamp":1756325403073,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,11,27]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p>Acute septic arthritis is a rare, potentially severe infection that requires immediate treatment to avoid long-term morbidity. Most common aetiological agents are commonly used for empirical treatment, but the choice of antibiotics may be influenced by other factors, such as the patient\u2019s age and the epidemiological context.<\/jats:p>\n               <jats:p>We report an infant with elbow arthritis, whose treatment was changed after <jats:italic>Streptococcus pneumoniae<\/jats:italic> serotype 9N was isolated in the blood and synovial fluid. The child underwent arthrocentesis and received intravenous ampicillin followed by oral amoxicillin, with a favourable response and no sequelae at 1-year follow-up.<\/jats:p>\n               <jats:p>We report an uncommon manifestation of invasive pneumococcal disease in a young immunised healthy infant caused by a non-vaccine serotype. The presence of <jats:italic>S. pneumoniae<\/jats:italic> should be considered in joint infections, especially in infants and those with a history of respiratory symptoms.<\/jats:p>","DOI":"10.1136\/bcr-2023-256888","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T12:41:55Z","timestamp":1702384915000},"page":"e256888","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Elbow septic arthritis in an infant: an unusual presentation of invasive pneumococcal disease"],"prefix":"10.1136","volume":"16","author":[{"given":"Paula","family":"Santos","sequence":"first","affiliation":[{"name":"Pediatrics, Centro Hospitalar do M\u00e9dio Tejo, Hospital Rainha Santa Isabel, Torres Novas, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catarina","family":"Gouveia","sequence":"additional","affiliation":[{"name":"Pediatrics, Centro Hospitalar de Lisboa Central, Hospital Dona Estefania, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joana","family":"Ov\u00eddio","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics, Centro Hospitalar de Lisboa Central, Hospital Dona Estefania, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catarina","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Pediatrics, Centro Hospitalar do M\u00e9dio Tejo, Hospital Rainha Santa Isabel, Torres Novas, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,12,12]]},"reference":[{"key":"2025082712573566000_16.12.e256888.1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.2147\/PHMT.S115429","article-title":"Septic arthritis in children: diagnosis and treatment","volume":"8","author":"P\u00e4\u00e4kk\u00f6nen","year":"2017","journal-title":"Pediatric Health Med Ther"},{"key":"2025082712573566000_16.12.e256888.2","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000003105"},{"key":"2025082712573566000_16.12.e256888.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2015.05.012"},{"key":"2025082712573566000_16.12.e256888.4","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1097\/INF.0000000000001697","article-title":"Osteoarticular infections caused by Streptococcus pneumoniae in children in the post-pneumococcal conjugate vaccine era","volume":"36","author":"Olarte","year":"2017","journal-title":"Pediatr Infect Dis J"},{"key":"2025082712573566000_16.12.e256888.5","doi-asserted-by":"crossref","unstructured":"Aguiar SI , Brito MJ , Hor\u00e1cio AN , et al . 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