Background: Neonatal hip septic arthritis is one of the rarest clinical conditions epidemiologically but with momentous long-term sequelae. Early detection and proper intervention have a paramount role in alleviating the shattering long-term effects. The clinical presentation of neonatal hip septic arthritis is very non-specific, with limited movement of the extremities and excessive crying during manipulations such as diaper changing. Our case was a 17-day-old male newborn who presented to our hospital after a family noticed decreased left leg movement and crying while changing diapers for 5 days, with the associated complaint of holding the left leg in a flexed position. The newborn then underwent all the available investigations and the diagnosis of hip septic arthritis was made. We were stunned by the culture result, which isolated Klebsiella pneumonia from the sample that had been taken from joint fluid, which is a very unusual isolate. Conclusion:Hip septic arthritis is an orthopedic emergency, especially in neonates. It should be considered in newborns presenting with pseudoparalysis as the presentation is nonspecific. Considering a less common microorganism with culture and sensitivity is very important, especially if the response to treatment is delayed. We endorse proper workup and timely intervention as hip arthritis has a poor prognosis when the management is delayed.
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