Acute Osteomyelitis in Children

Scott, Richard J.; Christofersen, Mark R.; Robertson, W. W.; Davidson, Richard S.; Rankin, Lynn M.; Drummond, Denis S.

doi:10.1097/01241398-199009000-00015

Cited by 124 publications

(43 citation statements)

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“…Histologically, it manifests itself as chronic osteomyelitis with a predominance of lymphocytes in the inflammatory infiltrate. The condition is an immunopathological process, possibly triggered by a bacteria, for example Proprionibacterium acnes; however, cultures are typically negative in contrast to bacterial osteomyelitis for which an organism (in this case Pseudomonas aeurginosa) is usually isolated [3,8,9]. Although the diagnosis of osteomyelitis was not delayed, we could not identify a predisposing condition to our patient's recalcitrant condition.…”

Section: Discussioncontrasting

confidence: 52%

Chronic haematogenous Pseudomonas aeruginosa osteomyelitis of the clavicle, a case report and review of the literature

Yousef

Pace²,

Livesley

2006

Eur J Pediatr

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Section: Discussioncontrasting

confidence: 52%

Chronic haematogenous Pseudomonas aeruginosa osteomyelitis of the clavicle, a case report and review of the literature

Yousef

Pace²,

Livesley

2006

Eur J Pediatr

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“…Laboratory parameters are used to help the clinician with evaluation. ESR is still the main yardstick in monitoring the course of illness [1,5,24,31]. Unfortunately, ESR increases rather arbitrarily and normalizes so slowly that active infection is likely to have resolved earlier than suggested by normalized ESR values [2,27].…”

Section: Introductionmentioning

confidence: 99%

Sensitivity of Erythrocyte Sedimentation Rate and C-reactive Protein in Childhood Bone and Joint Infections

Pääkkönen

Kallio

et al. 2010

Clinical Orthopaedics &Amp; Related Research

202

119

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“…9 Approximately half of pediatric acute osteomyelitis cases warrant surgical treatment in conjunction with standard medical management. 10 Therefore, pediatric orthopedic consultation is recommended.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Group A β-Hemolytic Streptococcus Osteomyelitis, Septic Arthritis, and Bacteremia in a Newborn

Mcelwain¹,

Jewell²

2004

Infectious Diseases in Clinical Practice

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O steomyelitis and septic arthritis are uncommon infections in neonates. However, because the potential for permanent disability and overwhelming sepsis is significant, complications of bones and joints infections in neonates are important. Group A b-hemolytic Streptococcus is a rare pathogen in the initial month of life. This case illustrates the link between neonatal osteomyelitis, septic arthritis, and bacteremia. CASE REPORTA 3-week-old immunocompetent female was admitted to the hospital for fever and leg pain/swelling. She was a former 38-week gestation infant with no infectious risk factors at birth. She was discharged from the hospital on day of life 2 and had been gaining weight appropriately at home. On the day of admission, the family noted the patient's right leg was swollen and tender; she was increasingly sleepy and had a rectal temperature of 38.88C. Her parents and half-sister were healthy. The patient presented to the primary care physician who confirmed the findings, and hospital admission was arranged.Vitals signs included rectal temperature 40.38C, respiratory rate 58 breaths/min, heart rate 154 beats/min; blood pressure 90/ 60 mm Hg. Oxygen saturation was 96% on room air. Physical examination revealed a tired appearing infant, who was looking about and acting hungry. Her HEENT, cardiac, genital, and abdominal examinations were unremarkable. Her lungs were clear, but moderate subcostal retractions were appreciated. Distal pulses were intact. The extremity examination revealed a swollen, erythematous, and tender right thigh ( Figs. 1 and 2).Laboratory reported a hemoglobin of 10.8 g/dL, a white blood cell count of 41.5 10 3 /mL (with 69% polymorphonuclear neutrophils, 12% band forms, and 10% lymphocytes), and a platelet count of 700 Â 10 3 /mL. Blood smear was not worrisome. Serum electrolytes and glucose were normal. Urinalysis was negative. Cerebral spinal fluid showed no red blood cells, no white blood cells, and normal glucose and protein. Blood, urine, and cerebral spinal fluid were collected for culture.A right femur film (Fig. 3) demonstrated a defect at the lateral portion of the distal metaphysis. The cortical bone was disrupted, and there was a ragged-edged lesion. No obvious fracture was appreciated. Orthopedics was consulted; the patient was escorted to the operating room for biopsy, culture, and irrigation. Twenty milliliters of frank pus was drained from the knee joint. Initial Gram stain of the knee aspirate confirmed gram-positive cocci in chains and clusters. Intravenous ceftriaxone and vancomycin were initiated.The patient remained stable following antibiotics and surgical drainage. Six hours after the blood culture was collected, it was positive for gram-positive cocci in chains. The blood and the knee aspirate cultures grew group A b-hemolytic Streptococcus, which was sensitive to vancomycin, ceftriaxone, penicillin, chloramphenicol, and clindamycin. Antibiotics were simplified to intravenous ampicillin. A repeat blood culture was negative. The urine and CSF cultures were neg...

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Acute Osteomyelitis in Children

Cited by 124 publications

References 0 publications

Chronic haematogenous Pseudomonas aeruginosa osteomyelitis of the clavicle, a case report and review of the literature

Chronic haematogenous Pseudomonas aeruginosa osteomyelitis of the clavicle, a case report and review of the literature

Sensitivity of Erythrocyte Sedimentation Rate and C-reactive Protein in Childhood Bone and Joint Infections

Group A β-Hemolytic Streptococcus Osteomyelitis, Septic Arthritis, and Bacteremia in a Newborn

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