Spinal infections in children

Dayer, Romain; Alzahrani, Mohammad M.; Saran, Neil; Ouellet, Jean; Journeau, Pierre; Tabard-Fougère, Anne; Martínez-Álvarez, S.; Ceroni, Dimitri

doi:10.1302/0301-620x.100b4.bjj-2017-1080.r1

Cited by 42 publications

(47 citation statements)

References 44 publications

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“…31 Twenty-nine articles were considered relevant with respect to identifying the number of confirmed infections with K. kingae in bacteriologically proven musculoskeletal infections in children (Table 1). 2,22,28,29,[32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][66][67][68][69][70] This was further studied to summarize the frequency of K. kingae infections among children under 48 months old ( Table 2). Additional epidemiological data extracted and collated included musculoskeletal infection sites, gender, age and seasonality.…”

Section: Search Findingsmentioning

confidence: 99%

Systematic Review of Kingella kingae Musculoskeletal Infection in Children: Epidemiology, Impact and Management Strategies

Wong¹,

Williams²,

Cooper³

2020

PHMT

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Kingella kingae, a pathogen often responsible for musculoskeletal infections in children is the most common cause of septic arthritis and osteomyelitis in children 6 to 36 months of age. The aim of this study was to perform a systematic review of previous studies to determine the proportion of K. kingae in bacteriologically proven musculoskeletal infections among the pediatric population. A secondary objective was to describe the diagnostic strategies and outcome of patients with musculoskeletal infections caused by K. kingae. A systematic review was conducted to identify publications that report on musculoskeletal infections caused by K. kingae in the pediatric population (patients 0 to <18 years old with microbiologic culture and/or polymerase chain reaction (PCR) confirmation of K. kingae and a description of the musculoskeletal infection involved). Of 144 studies included in this review, we sought to determine the proportion of K. kingae pediatric musculoskeletal infections. A total of 711 (30.8%) out of 2308 pediatric cases with culture and/or PCR proven musculoskeletal infections had K. kingae successfully identified from twenty-nine studies. Of the 1070 patients who were aged less than 48 months, K. kingae was the organism identified in 47.6% of infections. We found the average age from the collated studies to be 17.73 months. Of 520 pediatric musculoskeletal patients in which K. kingae infections were identified and where the studies reported the sites of infection, a large proportion of cases (65%) were joint infections. This was followed by 18.4% osteoarticular infection (concomitant bone and joint involvement), with isolated bone and spine at 11.9% and 3.5%, respectively. Twenty-one papers reported clinical and laboratory findings in children with confirmed K. kingae infection. The median temperature reported at admission was 37.9°C and mean was 38.2°C. Fourteen studies reported on impact and treatment, with the majority of children experiencing good clinical outcome and function following antibiotic treatment with no serious orthopaedic sequelae.

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Section: Search Findingsmentioning

confidence: 99%

Systematic Review of Kingella kingae Musculoskeletal Infection in Children: Epidemiology, Impact and Management Strategies

Wong¹,

Williams²,

Cooper³

2020

PHMT

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“…It typically occurs in children younger than 6 years, and the lumbar discs are most commonly affected, but any disc may be involved. [2][3][4] In most patients, spinal seeding occurs haematogenously from a previously existing site of infection. Pathogens however, can be exceptionally inoculated from a diagnostic/surgical procedure and following trauma.…”

Section: Descriptionmentioning

confidence: 99%

“…half of the cases no micro-organism can be identified, but when isolated Staphylococcus aureus prevails. [1][2][3][4] Clinical manifestations vary with age. It is not unusual for toddlers to present only with non-specific signs such as irritability, and not the classic low back pain and antalgic gait.…”

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confidence: 99%

“…A delay in establishing the diagnosis has been found, with studies reporting an average of 27 days going up to between 4 and 6 months. 4 MRI is highly sensitive for an early diagnosis and tandem to clinical evaluation, an excellent examination for monitoring disease progression. Treatment includes rest, nonsteroidal anti-inflammatory drugs, antibiotics, casting in some patients and physiotherapy if appropriate.…”

Section: Images In…mentioning

confidence: 99%

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Intermittent irritability in a toddler

Alexandre¹,

Castelão

Santos³

et al. 2021

BMJ Case Rep

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“…The estimated incidence of discitis and spondylodiscitis is 1–2 cases per year per 32,500 pediatric hospital evaluations [ 1 ], representing approximately 3% of all the cases of osteoarticular infections [ 2 ]. The age distribution of pediatric spondylodiscitis is triphasic: the first peak occurs in early childhood (79%), between the age of 6 months and 4 years, a smaller later peak in the juvenile and adolescent group (20%), and only exceptional infections in children aged under 6 months (1%) [ 3 ]. The lumbar region is the spine level predominately involved, and the most common causative organism is Staphylococcus aureus [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Infectious spondylodiscitis and kyphosis correction in an infant: a case report

et al. 2021

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Background Neonatal infectious spondylodiscitis is a rare bony infection with atypical clinical presentation and non-specific systemic symptoms. Diagnosis and treatment are often delayed resulting in vertebral destruction and severe complications. We retrospectively reviewed the case of an infant with infectious spondylodiscitis resulting in T12 body destruction and marked angular kyphosis. Case-report A 4-week-old infant developed an infectious spondylodiscitis resulting in destruction of the T12 vertebral body and involvement of disc between T12 and L1. At 6 months of age, X-ray showed a marked thoracolumbar angular kyphosis above 50 Cobb degrees. Therefore, the patient underwent single time surgery with double anterior and posterior approach. At 9 years follow up, clinical and radiological findings show a stable correction with good aesthetic appearance. Conclusion Neonatal spondylodiscitis could lead to marked kyphosis similar to the congenital one. Since treatment with casts and tutors is often inefficacious, prompt surgery should be considered. The double anterior and posterior approach is the best option in this condition.

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Spinal infections in children

Cited by 42 publications

References 44 publications

<p>Systematic Review of <em>Kingella kingae</em> Musculoskeletal Infection in Children: Epidemiology, Impact and Management Strategies</p>

<p>Systematic Review of <em>Kingella kingae</em> Musculoskeletal Infection in Children: Epidemiology, Impact and Management Strategies</p>

Intermittent irritability in a toddler

Infectious spondylodiscitis and kyphosis correction in an infant: a case report

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