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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Severe Pain While Walking After Adenoidectomy. ER Treated For Dehydration, Next Will Be Spinal Tap

Hi my 16 YO daughter just had a adenoidectomy done yesterday, this morning she yelled for me she could not walk her legs were pain she said severe pain, we rushed to the ER they are treating her for dehydration at this very moment, next they say it will be a spinal tap, I am going crazy worrying if my child will be ok what is going on ? what can this be?
Tue, 26 Nov 2013
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General & Family Physician 's  Response
hello,
the problem of your daghter might be an infection coming after her adenoidectomy. The fact that she can not walk and that she has pain indicates that the problem can be related with muscles, articulations or inervation.

The most common is artritis in my opinion that is an inflamation of the articulation that is very frequent in persons having infections in adenoid gland.
Bacteria that are commonly found to cause septic arthritis are:

Staphylococcus aureus - the most common cause in adults
Streptococci - the second most common cause

Micro-organisms must reach the synovial membrane of a joint. This can happen in any of the following ways:

dissemination of pathogens via the blood, from abscesses or wound infections, or from an unknown focus
dissemination from an acute osteomyelitic focus,
dissemination from adjacent soft tissue infection,
entry via penetrating trauma
entry via iatrogenic means.

A number of factors should increase one's suspicion of the presence of an infection. In children these are: fever > 38.5 C, non-weight-bearing, serum WBCs > 12 x 10^9, ESR > 40 mm/hr, CRP > 20 mg/dL, a previous visit for the same

Diagnosis is by aspiration (giving a turbid, non-viscous fluid), Gram stain and culture of fluid from the joint, as well as tell-tale signs in laboratory testing (such as a highly elevated neutrophils (approx. 90%),In the joint aspirate, the typical white blood cell count in septic arthritis is over 50,000-100,000 cells per 10-6/l (50,000-100,000 cell/mm3

Therapy is usually with intravenous antibiotics, analgesia and washout/aspiration of the joint to dryness. Among pediatric patients with an acute hematogenous septic arthritis a short total course of 10 days of antimicrobials is sufficient in uncomplicated cases

Kind regards
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Severe Pain While Walking After Adenoidectomy. ER Treated For Dehydration, Next Will Be Spinal Tap

hello, the problem of your daghter might be an infection coming after her adenoidectomy. The fact that she can not walk and that she has pain indicates that the problem can be related with muscles, articulations or inervation. The most common is artritis in my opinion that is an inflamation of the articulation that is very frequent in persons having infections in adenoid gland. Bacteria that are commonly found to cause septic arthritis are: Staphylococcus aureus - the most common cause in adults Streptococci - the second most common cause Micro-organisms must reach the synovial membrane of a joint. This can happen in any of the following ways: dissemination of pathogens via the blood, from abscesses or wound infections, or from an unknown focus dissemination from an acute osteomyelitic focus, dissemination from adjacent soft tissue infection, entry via penetrating trauma entry via iatrogenic means. A number of factors should increase one s suspicion of the presence of an infection. In children these are: fever 38.5 C, non-weight-bearing, serum WBCs 12 x 10^9, ESR 40 mm/hr, CRP 20 mg/dL, a previous visit for the same Diagnosis is by aspiration (giving a turbid, non-viscous fluid), Gram stain and culture of fluid from the joint, as well as tell-tale signs in laboratory testing (such as a highly elevated neutrophils (approx. 90%),In the joint aspirate, the typical white blood cell count in septic arthritis is over 50,000-100,000 cells per 10-6/l (50,000-100,000 cell/mm3 Therapy is usually with intravenous antibiotics, analgesia and washout/aspiration of the joint to dryness. Among pediatric patients with an acute hematogenous septic arthritis a short total course of 10 days of antimicrobials is sufficient in uncomplicated cases Kind regards