SUMMARYA retrospective study of 191 cases of septic arthritis was undertaken at Royal Darwin Hospital in the tropical north of Australia. Incidence was 9-2 per 100000 overall and 29 1 per 100000 in Aboriginal Australians (RR 6-6; 95 % CI 5 0-8 9). Males were affected more than females (RR 1 6; 95 % CI 1 2-2 1). There was no previous joint disease or medical illness in 54 %. The commonest joints involved were the knee (54%) and hip (13 %). Significant age associations were infected hips in those under 15 years and infected knees in those over 45 years. Seventytwo percent of infections were haematogenous. Causative organisms included Staphylococcus aureus (37%), Streptococcus pyogenes (16%) and Neisseria gonorrhoeae (12 %). Unusual infections included three melioidosis cases. Polyarthritis occurred in 17%, with N. gonorrhoeae (11/23) more likely to present as polyarthritis than other organisms (22/168) (OR 6-0; 95% CI 2 1-16-7). Univariate and multivariate analysis showed the hip to be at greater risk for S. aureus than other joints. Open arthrotomy was a more successful treatment procedure than arthroscopic washout or needle aspiration.

The epidemic of APSGN was associated with GAS skin infections. The mass use of penicillin may have had an effect in reducing the transmission of the nephritogenic strain of GAS. Microscopic haematuria was a significant finding in many of the children, and further prospective studies are required to understand the significance of this finding.

Congenital Zika virus syndrome consists of a large spectrum of neurologic abnormalities seen in infants infected with Zika virus in utero. However, little is known about the effects of Zika virus intrauterine infection on the neurocognitive development of children born without birth defects. Using a case-control study design, we investigated the temporal association of a cluster of congenital defects with Zika virus infection. In a nested study, we also assessed the early childhood development of children recruited in the initial study as controls who were born without known birth defects,. We found evidence for an association of congenital defects with both maternal Zika virus seropositivity (time of infection unknown) and symptomatic Zika virus infection during pregnancy. Although the early childhood development assessment found no excess burden of developmental delay associated with maternal Zika virus infection, larger, longer-term studies are needed.

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