{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:28:44Z","timestamp":1787754524852,"version":"build-2784847793"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JBJS Case Connector"],"published-print":{"date-parts":[[2015,8,12]]},"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A twenty-two-month-old boy with septic hip arthritis had persistent elevated inflammatory markers and daily fevers despite multiple antibiotic regimens and repeated surgical debridements yielding negative cultures. After exhaustive work-up for other infectious, rheumatologic, and immunologic etiologies, he met diagnostic criteria for hemophagocytic lymphohistiocytosis (HLH) and developed cultures positive for fungal hip arthritis. Following treatment for HLH and fungal hip arthritis, he improved and was discharged.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>No previous report in the literature specifically associates HLH with septic hip arthritis, to our knowledge. Surgeons should suspect underlying immunologic deficiencies and atypical infectious causes of septic arthritis when usual treatment modalities have failed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.n.00230","type":"journal-article","created":{"date-parts":[[2015,8,12]],"date-time":"2015-08-12T22:30:12Z","timestamp":1439418612000},"page":"e69","source":"Crossref","is-referenced-by-count":8,"title":["Septic Arthritis of the Hip in the Setting of Hemophagocytic Lymphohistiocytosis"],"prefix":"10.2106","volume":"5","author":[{"given":"William B.","family":"Acker","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Michigan, Mott Children\u2019s Hospital, SPC 4241, 1540 East Medical Center Drive, Ann Arbor, MI 48109"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Star L.","family":"Nixon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Michigan, Mott Children\u2019s Hospital, SPC 4241, 1540 East Medical Center Drive, Ann Arbor, MI 48109"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Michigan, Mott Children\u2019s Hospital, SPC 4241, 1540 East Medical Center Drive, Ann Arbor, MI 48109"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan A.","family":"Jacobson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Wayne State University, 18100 Oakwood Boulevard, Dearborn, MI 48124"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary","family":"Haftel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Communicable Diseases, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances A.","family":"Farley","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Michigan, Mott Children\u2019s Hospital, SPC 4241, 1540 East Medical Center Drive, Ann Arbor, MI 48109"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"6","key":"bib1-20231015","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.2106\/JBJS.E.00216","article-title":"Factors distinguishing septic arthritis from transient synovitis of the hip in children. A prospective study","volume":"88","author":"Caird","year":"2006","journal-title":"J Bone Joint Surg Am."},{"issue":"8","key":"bib2-20231015","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.2106\/00004623-200408000-00005","article-title":"Validation of a clinical prediction rule for the differentiation between septic arthritis and transient synovitis of the hip in children","volume":"86","author":"Kocher","year":"2004","journal-title":"J Bone Joint Surg Am."},{"issue":"12","key":"bib3-20231015","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.2106\/00004623-199912000-00002","article-title":"Differentiating between septic arthritis and transient synovitis of the hip in children: an evidence-based clinical prediction algorithm","volume":"81","author":"Kocher","year":"1999","journal-title":"J Bone Joint Surg Am."},{"issue":"5","key":"bib4-20231015","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1097\/01241398-199909000-00020","article-title":"Culture-negative septic arthritis in children","volume":"19","author":"Lyon","year":"1999","journal-title":"J Pediatr Orthop."},{"issue":"1","key":"bib5-20231015","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1182\/asheducation-2011.1.178","article-title":"Approach to hemophagocytic syndromes","volume":"2011","author":"Weitzman","year":"2011","journal-title":"Hematology Am Soc Hematol Educ Program."},{"issue":"4","key":"bib6-20231015","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1111\/j.1651-2227.1991.tb11878.x","article-title":"Incidence in Sweden and clinical features of familial hemophagocytic lymphohistiocytosis","volume":"80","author":"Henter","year":"1991","journal-title":"Acta Paediatr Scand."},{"issue":"2","key":"bib7-20231015","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1002\/pbc.21039","article-title":"HLH-2004: diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis","volume":"48","author":"Henter","year":"2007","journal-title":"Pediatr Blood Cancer."},{"issue":"15","key":"bib8-20231015","doi-asserted-by":"crossref","first-page":"4041","DOI":"10.1182\/blood-2011-03-278127","article-title":"How I treat hemophagocytic lymphohistiocytosis","volume":"118","author":"Jordan","year":"2011","journal-title":"Blood."},{"issue":"4","key":"bib9-20231015","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1002\/art.38296","article-title":"Effectiveness of first-line treatment with recombinant interleukin-1 receptor antagonist in steroid-naive patients with new-onset systemic juvenile idiopathic arthritis: results of a prospective cohort study","volume":"66","author":"Vastert","year":"2014","journal-title":"Arthritis Rheumatol."},{"issue":"2","key":"bib10-20231015","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.rdc.2012.04.006","article-title":"Early juvenile idiopathic arthritis","volume":"38","author":"Marzan","year":"2012","journal-title":"Rheum Dis Clin North Am."},{"issue":"10","key":"bib11-20231015","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.1086\/323675","article-title":"The role of infections in primary hemophagocytic lymphohistiocytosis: a case series and review of the literature","volume":"33","author":"Sung","year":"2001","journal-title":"Clin Infect Dis."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01709767-201505030-00015","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:28:47Z","timestamp":1787750927000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01709767-201505030-00015"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2015,8,12]]},"references-count":11,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2015]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.n.00230","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8,12]]}}}