Osteoarticular Infections At A Pediatric Emergency Core Hospital In Japan

Abstract

Objectives: Osteomyelitis (OM) and septic arthritis (SA) in childhood might cause complications, sequelae, or even death if diagnosis and treatment are delayed. Early diagnosis of pediatric OM/SA depends on a healthcare system that is easily accessible and provides multidisciplinary management and early imaging studies. Here, we examined the outcomes of OM/SA at a pediatric emergency core hospital in Japan.Methods: This was a single-center, retrospective, observational cohort study conducted at Tokushima Prefectural Central Hospital, a pediatric emergency core hospital in Japan. Pediatric outpatients who underwent magnetic resonance imaging at the hospital in the period 2012–2020 were recruited. Primary outcomes were sequelae, recurrent symptoms, chronicity, and death. The data collected included time from onset to first hospital visit, hospitalization, and initiation of effective antibiotics.Results: Fifteen OM/SA patients (9 OM, 4 SA, 2 OM+SA) were recruited. In these patients, symptoms were fever (100 %, n = 15), pain (93.3 %, n = 14), limited range of motion (73.3 %, n = 11), swelling (40.0 %, n = 6), and reluctance to feed (46.7 %, n = 7). The identified major pathogens included methicillin-susceptible Staphylococcus aureus (40.0 %, n = 6) and methicillin-resistant S. aureus (13.3 %, n = 2). Mean time from onset to first hospital visit, hospitalization, and initiation of effective antibiotics was 2 days, 3.9 ± 1.8 days, and 4.9 ± 2.2 days, respectively. All OM/SA patients recovered without complications or sequelae.Conclusions: In this study, all patients with OM/SA showed a good prognosis. Despite the small sample size, this pilot study suggests that the pediatric emergency core system in Japan provides early treatment and a good prognosis for patients diagnosed with OM/SA.