Brachial plexus neuropathy - a rare manifestation of osteoarticular infection
Keywords:brachial palsy, neuropathy, osteoarticular infection, osteomyelitis, septic arthritis
Background: Brachial palsy is a rare condition beyond the neonatal period. Usually it is caused by physical mechanisms, but may be related with osteo-articular infections. There are few cases describing the association between these infections and true nerve paralysis. On the other hand, pseudo-paralysis or apparent weakness of a limb associated with septic arthritis or osteomyelitis is a well-documented phenomenon
Case Report: We describe three cases of osteoarticular infection manifested by flaccid limb paralysis without the typical systemic signs of infection. The timing of rcognition differed among the cases, as well as the therapeutic interventions and the outcome.
Discussion: Osteo-articular infections may go unrecognized in infancy. We highlight this rare manifestation of osteo-articular infection to avoid the delay in diagnosis and associated sequelae.
Pavone V, Politi MR, Vecchio M, Romano C, Falsaperla R, Pavone P et al. Plexus Neuropathy in Infants Secondary to Arthro-Osteomyelitis: Report of 2 Cases and Review of the Literature. Int J Clin Pediatr 2012; I (4-5): 136-40.
Sadleir LG, Connolly MB. Acquired brachial plexus neuropathy in the neonate: a rare presentation of late onset group-B streptococcal osteomyelitis. Dev Med Child Neurol 1998; 40:496-9.
Alfonso DT. Causes of Neonatal Brachial Plexus Palsy. B Hosp Joint Dis Ort 2011; 69(1): 11-6.
Min-Kyu Nar, Ka Em Kua, Chun-Hung Wu. Septic Arthritis and Acute Osteomyelitis in Early Infancy. J Clin Neonatol 1999; Vol.6 No.2.
Isaacs D, Bower BD, Moxon ER. Neonatal osteomyelitis presenting as nerve palsy. Br Med J (Clin Res Ed) 1986; 292: 1071.
Gabriel SR, Thometz JG, Jaradeh S. Septic arthritis associated with brachial plexus neuropathy. J Bone Joint Surg Am 1996; 78 A: 103-5.
Estienne M, Scaioli V, Zibordi F, Angelini L. Enigmatic Osteomyelitis and Bilateral Upper Limb Palsy in a Neonate. Pediatr Neurol 2005; 32: 56-9.
Mascarenhas A, Almeida C, Constantino C, Soudo AP, Calado E, Vieira JP. Septic arthritis presenting as brachial plexus neuropathy. BMJ Case Rep 2011 10.1136/ bcr.12.2010.3562.
Yuille TD. Limb infections in infancy presenting with pseudoparalysis. Arch Dis Child 1975; 50: 953.
Bennet GC, Harrold AJ. Prognosis and early management of birth injuries to the brachial plexus. BMJ 1976; 1: 1520-1.
Clay SA. Osteomyelitis as a cause of brachial plexus neuropathy. Am J Dis Child 1986; 136: 1054-6.
Bos CFA, Mol LJCD, Obermann WR, Tjin a Ton ER. Late sequelae of neonatal septic arthritis of the shoulder. J Bone Joint Surg Br 1998; 80-B: 645-50.
How to Cite
Copyright and access
This journal offers immediate free access to its content, following the principle that providing free scientific knowledge to the public provides greater global democratization of knowledge.
The works are licensed under a Creative Commons Attribution Non-commercial 4.0 International license.
Nascer e Crescer – Birth and Growth Medical Journal do not charge any submission or processing fee to the articles submitted.