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Osteomyelitis in childrens

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https://www.readbyqxmd.com/read/28534215/-acute-haematogenous-osteomyelitis-in-children-diagnostic-algorithm-and-treatment-strategies
#1
M Willegger, A Kolb, R Windhager, C Chiari
Acute haematogenous osteomyelitis (AHO) in children is a severe condition. A delay in diagnosis and insufficient treatment may result in deformities, chronicity and sepsis. Therefore a structured diagnostic workup has to be followed in order to diagnose or rule out osteomyelitis. To identify the causative agent for targeted antibiotic treatment, a bone biopsy or puncture should be performed. However, approximately 25% of cases are culture-negative even after biopsy. The knowledge of the typical age-dependent bacterial spectrum is essential for empirical antibiotic therapy...
May 22, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28528870/recurrent-multifocal-osteomyelitis-in-children-experience-in-a-tertiary-care-center
#2
Ana Belén Ariza Jiménez, Esmeralda Núñez Cuadros, Rocío Galindo Zavala, Leticia Núñez Caro, Gisela Díaz-Cordobés Soriano, Antonio Urda Cardona
INTRODUCTION: Chronic recurrent multifocal osteomyelitis is a rare aseptic bone inflammation that affects pediatric patients. Its management and treatment have not yet been standardized. METHODS: Retrospective, descriptive study of patients under 14 years of age diagnosed with chronic nonbacterial osteomyelitis (CNBO) in a tertiary hospital. We included patients diagnosed over the last 6 years (2010-2015) who met the Jansson criteria. The clinical and radiological characteristics of CNBO were analyzed, as was the outcome after different therapeutic options...
May 18, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28514223/hematogenous-osteomyelitis-in-infants-and-children-imaging-of-a-changing-disease
#3
Diego Jaramillo, John P Dormans, Jorge Delgado, Tal Laor, Joseph W St Geme
In children, hematogenous osteomyelitis is an infection that primarily affects the most vascularized regions of the growing skeleton. The disease has increased in frequency, virulence, and degree of soft-tissue involvement. The change in clinical manifestations and management over the past 2 decades should be reflected in the current imaging approach to the disease. Imaging of infection must depict the location of a single focus or of multiple foci of involvement and the presence of drainable collections. This review provides an overview of the imaging implications directed by the changing epidemiology, the newer insights of anatomy and pathophysiology, the imaging characteristics with emphasis on specific locations and disease complications, and the differential diagnosis considerations...
June 2017: Radiology
https://www.readbyqxmd.com/read/28507977/a-sub-acute-septic-arthritis-of-the-knee-a-sequelae-to-thorn-prick-injury-of-patella-a-case-report
#4
R Sivakumar, Prahalad Kumar Singhi, M Chidambaram, V Somashekar, Vinoth Thangamani
INTRODUCTION: Sub-acute septic arthritis of knee following a thorn prick injury to patella is an uncommon condition and seen in active playful children. The child may be afraid to narrate the incident to their parents or examining doctor, so a high index of suspicion is must. The delayed presentation is inevitable. Early synovitis due to the organic biological foreign body may progress to septic arthritis, if untreated may result in knee stiffness or chronic osteomyelitis of patella. CASE REPORT: We report a case of thorn prick injury to the left patella in an 8-years-old boy who neglected the incident of thorn prick while playing with his peer group 10 days ago and presented with features of sub-acute septic arthritis...
November 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28491221/isolated-tuberculosis-of-metacarpal-bone-in-a-3-year-old-child
#5
El Mouhtadi Aghoutane, Tarik Salama, Redouane El Fezazi
Primary tuberculosis osteomyelitis of metacarpal bone is rare. The majority of cases occur in children and young adults and there is difficulty in diagnosis mainly in young children. We report a new case in children aged of 3 years, presenting a swelling on the dorsal side of her right hand since 8 months. X-ray showed an expansile, cystic and lytic lesion involving the little finger metacarpal. Tuberculosis was confirmed on histological examination. No lesions in lung parenchyma or lymphadenopathy were associated...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28486628/chronic-recurrent-multifocal-osteomyelitis-in-children-and-adults-current-understanding-and-areas-for-development
#6
Marion R Roderick, Ethan S Sen, Athimalaipet V Ramanan
Since the first descriptions of chronic recurrent multifocal osteomyelitis in the 1970s, there have been numerous case reports in the literature; both unusual case reports and case series from all over the world. Our understanding of the pathogenesis has significantly changed, with it now being regarded as an autoinflammatory condition. Treatment options have also expanded, but little progress has been made in developing the evidence for treatments. Advancing gene studies have provided a mouse model, but the quest for a single gene to match the phenotype has been elusive...
April 6, 2017: Rheumatology
https://www.readbyqxmd.com/read/28484657/osteomyelitis-of-the-patella-in-a-10-year-old-girl-a-case-report-and-review-of-the-literature
#7
Matthias Sperl, Michael Novak, Daniela Sperl, Martin Svehlik, Georg Singer, Tanja Kraus
The incidence of osteomyelitis constantly declines. While the disease most commonly affects the long bones, involvement of the patella is rarely seen. Due to this rarity and the variable clinical presentation, diagnosis is often delayed. The present case report describes a 10-year-old female patient with a delayed diagnosis of patella osteomyelitis. The diagnostic procedures and the treatment regimen are described. Additionally, a detailed literature review of the available publications reporting osteomyelitis of the patella in children is presented...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28477437/national-epidemiological-study-reveals-longer-paediatric-bone-and-joint-infection-stays-for-infants-and-in-general-hospitals
#8
E Laurent, L Petit, Z Maakaroun-Vermesse, L Bernard, T Odent, L Grammatico-Guillon
AIM: Published studies have suggested that 2-5 days of intravenous treatment could effectively treat paediatric bone and joint infections (PBJI), allowing a faster discharge. This study analysed the factors associated with PBJI hospital stays lasting longer than five days using the French National Hospital Discharge Database. METHODS: We selected children under 15 years hospitalised in 2013 with haematogenous PBJIs using a validated French algorithm based on specific diagnosis and surgical procedure codes...
May 6, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28471400/epidemiology-and-management-of-acute-haematogenous-osteomyelitis-in-a-tertiary-paediatric-center
#9
Elena Chiappini, Caterina Camposampiero, Simone Lazzeri, Giuseppe Indolfi, Maurizio De Martino, Luisa Galli
Background: Paediatric acute hematogenous osteomyelitis (AHOM) is a serious disease requiring early diagnosis and treatment. To review the clinical presentation, management and organisms responsible for AHOM, and to explore risk factors for complicated AHOM, a large cohort referring to a single center over a 6-year period was evaluated. Methods: Data from children with AHOM, hospitalized between 2010 and 2015, and aged > 1 month, were retrospectively collected and analyzed. Results: 121 children (median age 4...
May 4, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28461645/treatment-response-and-longterm-outcomes-in-children-with-chronic-nonbacterial-osteomyelitis
#10
Anja Schnabel, Ursula Range, Gabriele Hahn, Reinhard Berner, Christian M Hedrich
OBJECTIVE: The autoinflammatory bone disorder chronic nonbacterial osteomyelitis (CNO) covers a wide clinical spectrum, ranging from mild self-limited presentations to chronically active or recurrent courses, which are then referred to as chronic recurrent multifocal osteomyelitis (CRMO). Little is known about treatment options and longterm outcomes. We investigated treatment responses and outcomes in children with CNO. METHODS: A retrospective chart review was conducted in a tertiary referral center, covering 2004-2015...
May 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28450986/-major-sickle-cell-syndromes-and-infections-associated-with-this-condition-in-children-in-burkina-faso
#11
Sonia Douamba, Kisito Nagalo, Laure Tamini, Ismaël Traoré, Madibèlè Kam, Fla Kouéta, Diarra Yé
INTRODUCTION: This study aims to investigate infections in children with major sickle cell syndrome. METHODS: We conducted a monocentric descriptive retrospective hospital study in Ouagadougou, Burkina Faso, over a ten-year period. All children with major sickle cell syndrome (homozygous SS and double heterozygous SC, SDPunjab, Sβ thalassemic, SOArab and SE) hospitalized for microbiologically confirmed infections were enrolled in the study. RESULTS: One hundred and thirty-three patients met our inclusion criteria...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28419275/clinical-care-guideline-for-improving-pediatric-acute-musculoskeletal-infection-outcomes
#12
Murray D Spruiell, Justin Benjamin Searns, Travis C Heare, Jesse L Roberts, Erin Wylie, Laura Pyle, Nathan Donaldson, Jaime R Stewart, Heather Heizer, Jennifer Reese, Halden F Scott, Kelly Pearce, Colin J Anderson, Mark Erickson, Sarah K Parker
Background.: Acute pediatric musculoskeletal infections are common, leading to significant use of resources and antimicrobial exposure. In order to decrease variability and improve the quality of care, Children's Hospital Colorado implemented a clinical care guideline (CCG) for these infections. The purpose of this study is to evaluate clinical and resource outcomes PRE and POST this CCG. Methods.: Retrospective chart review evaluated patients admitted to a large pediatric quaternary referral center (CHCO) diagnosed with acute osteomyelitis, septic arthritis, pyomyositis, and/or musculoskeletal abscess prior to and after guideline implementation...
April 17, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28417857/nuclear-medicine-imaging-in-pediatric-infection-or-chronic-inflammatory-diseases
#13
REVIEW
Alberto Signore, Andor W J M Glaudemans, Olivier Gheysens, Chiara Lauri, Onofrio A Catalano
In this review article, we focus on the most recent applications of nuclear medicine techniques (mainly (99m)Tc/(111)In white blood cells (WBC) scan, [(18)F]-FDG-PET/CT, [(18)F]-FDG-PET/MRI, and (99m)Tc-IL-2 scintigraphy) in the study of children affected by peripheral bone osteomyelitis, fungal infections, inflammatory bowel diseases, and type 1 diabetes, owing to recent important published evidences of their role in the management of these diseases. For osteomyelitis in children, both bone scintigraphy and [(18)F]-FDG-PET have a major advantage of assessing the whole body in one imaging session to confirm or exclude multifocal involvement, whereas WBC scan has a limited role...
May 2017: Seminars in Nuclear Medicine
https://www.readbyqxmd.com/read/28417851/nuclear-medicine-techniques-in-pediatric-bone-imaging
#14
REVIEW
Laura A Drubach
An important mandate when imaging pediatric patients is the reduction of radiation exposure to the lowest possible level consistent with good quality diagnostic imaging, so individual selection of radiopharmaceutical dosage and imaging technique is essential. Although the logistics of image acquisition and the approach to interpretation mirror the more common use in adults, the challenges of imaging young children typically require greater attention to patient preparation, positioning, and supervision during imaging, with the use of parental or family engagement in the procedure, gentle restraint, and occasionally the need for sedation...
May 2017: Seminars in Nuclear Medicine
https://www.readbyqxmd.com/read/28410697/multifocal-pure-tubercular-osteomyelitis-an-unusual-presentation-in-childhood
#15
Sananda Pati, Sangita De, Tarak Nath Ghosh, Mrinal Kanti Ghosh
Tuberculosis is a major health problem in the developing world. One-third of children infected with Mycobacterium tuberculosis have extra pulmonary involvement. Skeletal tuberculosis occurs in 1-6% of them with vertebra being the commonest site. Pure tubercular osteomyelitis without joint involvement occurs in only 2-3% cases of osteoarticular tuberculosis. Common sites are femur, tibia, and fibula. Disseminated skeletal involvement is very rare in children (7%) and calvarial osteomyelitis is even rarer (1%)...
April 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28403046/bacterial-osteomyelitis-or-nonbacterial-osteitis-in-children-a-study-involving-the-german-surveillance-unit-for-rare-diseases-in-childhood
#16
MULTICENTER STUDY
Veit Grote, Colen C G Silier, Agnes M Voit, Annette F Jansson
BACKGROUND: Although bacterial osteomyelitis (BO) is a commonly recognized diagnosis in pediatrics, it is often difficult to distinguish from nonbacterial osteitis (NBO). The goal of our study was to distinguish between the 2 disease entities and better define NBO. METHODS: Using the German Surveillance Unit for Rare Diseases in Childhood (Erhebungseinheit für Seltene Paediatrische Erkrankungen in Deutschland), this prospective study during a 5-year period captured 657 patients at first diagnosis of either BO (n = 378) or NBO (n = 279) while analyzing epidemiologic, clinical and radiologic data...
May 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28401741/oral-alendronate-in-pediatric-chronic-recurrent-multifocal-osteomyelitis
#17
Daishi Hirano, Kosuke Chiba, Saya Yamada, Hiroyuki Ida
Chronic recurrent multifocal osteomyelitis (CRMO) primarily affects children and adolescents, and is characterized by episodic sterile osteomyelitis over several years. No definitive treatment is available. Non-steroidal anti-inflammatory drugs (NSAID) are common first-line agents, but provide limited improvement in bone pain and do not affect disease duration. Several agents are utilized in the case of non-response to NSAID, including corticosteroids, methotrexate, and tumor necrosis factor-blocking agents...
April 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28401420/an-update-on-the-pathogenesis-and-treatment-of-chronic-recurrent-multifocal-osteomyelitis-in-children
#18
REVIEW
Andrea Taddio, Floriana Zennaro, Serena Pastore, Rolando Cimaz
Chronic recurrent multifocal osteomyelitis (CRMO), also known as chronic non-bacterial osteomyelitis (CNO), is a rare inflammatory disorder that primarily affects children. It is characterized by pain, local bone expansion, and radiological findings suggestive of osteomyelitis, usually at multiple sites. CRMO predominantly affects the metaphyses of long bones, but involvement of the clavicle or mandible are suggestive of the diagnosis. CRMO is a diagnosis of exclusion, and its pathogenesis remains unknown. Differential diagnosis includes infection, malignancies, benign bone tumors, metabolic disorders, and other autoinflammatory disorders...
June 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28387490/-an-rare-complication-of-scarlet-fever-invasive-group-a-streptococcal-infection-with-streptococcal-toxic-shock-syndrome
#19
H Warnier, Z Depuis, K Nyamugabo, B Desprechins, M-C Seghaye
Invasive Group A Streptococcus infections and streptococcal toxic shock syndrome are rare complications of common diseases in children such as scarlet fever or impetigo. These invasive diseases are particulary challenging because of their rapid progression and the lack of predisposing factors in most cases. Prompt diagnosis and treatment are mandatory to reduce the mortality associated with these severe diseases. We report the case of an 8- year-old girl who developped an invasive group A streptococcal disease with osteomyelitis and streptococcal toxic shock syndrome in the course of a classical scarlet fever...
March 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28382572/current-clinical-trials-on-the-use-of-ceftaroline-in-the-pediatric-population
#20
REVIEW
Adam Corey, Tsz-Yin So
The rate of antibiotic resistance in children continues to rise requiring the use of new antibiotics. Ceftaroline fosamil, a newer-generation cephalosporin, was recently approved for the treatment of acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia in children aged >2 months. Ceftaroline provides coverage against staphylococcal and streptococcal infections, including methicillin-resistant Staphylococcus aureus and penicillin-resistant Streptococcus pneumoniae...
April 5, 2017: Clinical Drug Investigation
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