Pediatric Acute Hematogenous Osteomyelitis

Street, Matthew; Puna, Rupesh; Huang, Mark E.; Crawford, Haemish

doi:10.1097/bpo.0000000000000332

Cited by 70 publications

(91 citation statements)

References 36 publications

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“…These infections are more common in males than in females (with incidences in French children of 24 per 100,000 person-years for boys and 19 per 100,000 personyears for girls) and in toddlers than in other age groups (494,495). Some ethnic groups may be at higher risk, with Maori and Pacific Islander populations being overrepresented in a study involving 813 cases of acute OM in New Zealand (496) Clinical manifestations and outcomes. Acute hematogenous OM in children presents with fever and malaise, local pain, and point tenderness and most commonly involves the metaphysis of the tibia or the femur, resulting in limping or an inability to walk (500).…”

Section: Osteoarticular Infections In Childrenmentioning

confidence: 99%

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

et al. 2015

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SUMMARY Staphylococcus aureus is a major human pathogen that causes a wide range of clinical infections. It is a leading cause of bacteremia and infective endocarditis as well as osteoarticular, skin and soft tissue, pleuropulmonary, and device-related infections. This review comprehensively covers the epidemiology, pathophysiology, clinical manifestations, and management of each of these clinical entities. The past 2 decades have witnessed two clear shifts in the epidemiology of S. aureus infections: first, a growing number of health care-associated infections, particularly seen in infective endocarditis and prosthetic device infections, and second, an epidemic of community-associated skin and soft tissue infections driven by strains with certain virulence factors and resistance to β-lactam antibiotics. In reviewing the literature to support management strategies for these clinical manifestations, we also highlight the paucity of high-quality evidence for many key clinical questions.

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Section: Osteoarticular Infections In Childrenmentioning

confidence: 99%

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

et al. 2015

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“…Ganz offensichtlich gibt es hier große regionale, auch ethnische Unterschiede. In hoch entwickelten Industriestaaten liegt die Inzidenz bei acht auf 100 000 Kindern unter zwölf Jahren, in Afrika und auch in Neukaledonien und Neuseeland, dort vor allem unter der polynesischen und Maori-Bevölkerung deutlich höher (1)(2)(3). In Schottland hat sich die Inzidenz über eine Zeitspanne von zwanzig Jahren um 50 Prozent verringert und liegt nun bei 2,9 pro 100 000 Einwohner (4).…”

Section: Discussionunclassified

Die akute Osteomyelitis des Kindes

Wirth¹

2017

Osteologie

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ZusammenfassungDie akute hämatogene Osteomyelitis ist eine schwere Erkrankung im Kindesalter, die bei verzögerter Diagnose und Therapie bleibende Schäden am Skelettapparat verursachen kann. Die Virulenz der Erkrankung kann von einer unterschwelligen Betroffenheit bis zu septischen Krankheitsbildern reichen. Das Keimspektrum hat sich über die Jahre verändert, aktuell ist Staphylococcus aureus der häufigste ursächliche Keim. Der prozentuale Anteil der Methicillin-resistenten Spezies (MRSA) variiert regional beträchtlich. Eine schnelle Diagnose unter Berücksichtigung der klinischen Symptome, des Labors und der bildgebenden Diagnostik, in der die Sonografie und das MRT die größte Bedeutung besitzen, ist die Basis. Die Therapie wird im Sinne einer Notfallindikation entweder konservativ antibiotisch oder zusätzlich durch operative Maßnahmen sofort eingeleitet. Die Operationen dienen zur Entlastung von intraossären, subperiostalen und Weichteilabszessen oder zur Kürettage und Ausräumung nekrotischen Knochens. Eine begleitende Gelenkinfektion wird arthroskopisch gespült. Folgeoperationen sind keine Seltenheit. Die Dauer der anti-biotischen Behandlung orientiert sich an der Schnelligkeit der Normalisierung des klinischen Bildes und des CRP-Wertes. Trotz suffizienter Frühbehandlung kann es zu Spätfolgen wie Rezidiven, Wachstumsstörungen und geschädigten Gelenken kommen.

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“…The complications of sepsis are very diverse and severe involving almost every organ. Infectious arthritis and acute osteomyelitis in children are usually a result of haematogenous bacterial spread, and the most frequent the causative agent is Staphylococcus aureus (80%), though others such as Streptococcus pneumoniae and Haemophilus influenza can be involved [13][14][15]. In one study, Staphylococcus aureus was the causative organism in 54% of the cases of osteomyelitis and septic arthritis [13].…”

Section: Discussionmentioning

confidence: 99%

Complications of Sepsis in Infant. A Case Report

Meliţ

Mărginean

Georgescu

et al. 2016

The Journal of Critical Care Medicine

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Sepsis is a systemic inflammatory response (SIRS) characterized by two or more of the following: fever > 38.5 °C or <36 °C, tachycardia, medium respiratory frequency over two SD for age, increased number of leukocytes. The following is a case of an eight months old, female infant, admitted in to the clinic for fever (39.7 C), with an onset five days before the admission, following trauma to the inferior lip and gum. Other than the trauma to the lip and gum, a clinical exam did not reveal any other pathological results. The laboratory tests showed leukocytosis, positive acute phase reactants (ESR 105 mm/h, PCR 85 mg/dl), with positive blood culture for Staphylococcus aureus MSSA. at 24 hours. Three days from admission, despite the administration of antibiotics (Vancomycin+Meronem), there was no remission of fever, and the infant developed a fluctuant collection above the knee joint. This was drained, and was of a serous macroscopic nature. A decision was made to perform a CT, which confirmed the diagnosis of septic arthritis. At two days after the intervention, the fever reappeared, therefore the antibiotic regime were altered (Oxacillin instead of Vancomycin), resulting in resolution of the fever. Sepsis in infant is a complex pathology, with non-specific symptoms and unpredictable evolution.

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Pediatric Acute Hematogenous Osteomyelitis

Abstract: Level IV-retrospective case series.

Cited by 70 publications

References 36 publications

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

Die akute Osteomyelitis des Kindes

Complications of Sepsis in Infant. A Case Report

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