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Septic Arthritis — RACP Paediatrics MCQ

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ModerateInfectious DiseaseSeptic ArthritisRACP Paediatrics

A 7-year-old previously well child presents with 7 days of fever and no clear focus. Blood cultures grow Staphylococcus aureus. He complains of right knee pain and limp. Examination shows a warm, swollen, erythematous right knee with limited range of motion. What is the most appropriate initial management?

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Correct answer: D — IV flucloxacillin and urgent joint aspiration/washout

Septic arthritis in a child requires urgent joint aspiration (for culture and Gram stain) and washout (either by arthroscopy or open surgery), combined with IV anti-staphylococcal antibiotics (IV flucloxacillin is first-line in Australia for MSSA). Delay in drainage risks permanent cartilage damage. Treatment is not delayed for MRI. IV-to-oral switch can occur when clinically improving.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Septic Arthritis