SALMONELLA SEPTIC ARTHRITIS OF THE SHOULDER IN ZAMBIAN CHILDREN

Nineteen children under the age of two with salmonella septic arthriti s (SSA) of the shoulder presented to Mukinge Hospital between 1st Janu ary 1992 and 31st March 1993. There were 13 boys and six girls. All pa tients were below the 50th centile for weight. The most common present ation was swelling, pyrexia and non-use of the arm. Pain was not alway s present. All patients were anaemic but in many cases had both WBC an d ESR in the normal range. All patients were treated with drainage and antibiotics. All made a good recovery and were discharged pain free, apyrexial and using the affected arm. One patient was re-admitted beca use of recurrent infection. Nine patients reviewed after one month had continued good function with no clinical sign of infection. We conclu de that where intestinal salmonella are endemic, low nutritional statu s is likely to be a factor in the development of a bacteraemia, and th at the intra-articular extension of the proximal humeral metaphysis an d repetitive minor trauma to the joint are predisposing factors to the development of shoulder infection.