# Aeromonas veronii-induced septic arthritis of the hip in a child with acute lymphoblastic leukemia

## TL;DR

A child with leukemia developed rare hip infection caused by Aeromonas veronii, successfully treated with antibiotics after advanced testing identified the pathogen.

## Contribution

Reports a rare case of Aeromonas veronii-induced septic arthritis in an immunosuppressed child, highlighting metagenomic sequencing for rapid diagnosis.

## Key findings

- Aeromonas veronii was identified as the cause of septic arthritis using metagenomic next-generation sequencing.
- The child was successfully treated with a combination of amikacin and imipenem–cilastatin.
- mNGS is suggested as a valuable tool for detecting rare infections in immunocompromised patients.

## Abstract

Septic arthritis of the hip (SAH) is a prevalent form of infectious arthritis in children that can lead to serious complications if not promptly diagnosed and treated. A 6-year 4-month-old female child with a 1-year history of acute lymphoblastic leukemia chemotherapy was admitted to our hospital due to a 1-day fever. After 1 week, the child experienced right inguinal pain and exhibited severe restriction in the flexion of the right lower limb and hip. Consequently, edema was observed in the right lower extremity and foot. SAH was initially diagnosed using computed tomography and magnetic resonance imaging examinations of both hip joints. Subsequently, incision and irrigation procedure were performed on the hip joint. Following the surgery, pus metagenomic next-generation sequencing (mNGS) were conducted promptly, and the mNGS analysis indicated an Aeromonas veronii infection. The diagnosis of A. veronii SAH was subsequently confirmed through polymerase chain reaction. The child’s condition was successfully treated with a combination of amikacin and imipenem–cilastatin, leading to improvement and subsequent discharge in a satisfactory state. SAH caused by A. veronii is a rare occurrence, and the utilization of mNGS holds significant potential for the early detection of uncommon infections in immunosuppressed children.