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Osteomyelitis in childrens

Elizabeth Wilson, Peter Cox, Karen Greaves, Siba Prosad Paul
Children with acute onset non-traumatic limp often present to emergency departments (EDs). The limp can occasionally be associated with medical emergencies such as septic arthritis and slipped upper femoral epiphysis but is often due to less severe conditions. This article discusses the common and self-limiting causes of acute onset of non-traumatic limp in children, such as transient synovitis, reactive arthritis, and benign acute childhood myositis. It also discusses more severe conditions, including septic arthritis, osteomyelitis, slipped upper femoral epiphysis, Perthes disease, malignancies and non-accidental injury...
March 9, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
Olugbenga Akinkugbe, Charles Stewart, Caoimhe McKenna
OBJECTIVE: The objective of this study was to evaluate the presenting features of bone and joint infections with a view to identify distinguishing trends that will be useful for pediatric emergency departments. METHODS: We performed a retrospective review of patient records over a 12-year period in the pediatric emergency department of a large regional pediatric teaching center serving a diverse population. RESULTS: There were 88 cases of osteoarticular infections during the study period...
March 5, 2018: Pediatric Emergency Care
Canyang Zhan, Jing Du, Lihua Chen
BACKGROUND: Acute osteomyelitis, which is uncommon in neonates, needs to be quickly diagnosed and treated to avoid devastating sequelae. Therefore, it is important to maintain a high index of suspicion and be aware of the evolving epidemiology and of the emergence of antibiotic resistant and aggressive strains requiring careful monitoring and targeted therapy. The most frequently isolated bacterium in neonates with osteomyelitis is Staphylococcus aureus, while Salmonella is an unusual organism causing osteomyelitis and is exceedingly rare in non-sickle cell disease children...
February 26, 2018: Italian Journal of Pediatrics
Marguerite T Parisi, Jeffrey P Otjen, A Luana Stanescu, Barry L Shulkin
With the exception of radiolabeled monoclonal antibodies, antibody fragments and radiolabeled peptides which have seen little application in the pediatric population, the nuclear medicine imaging procedures used in the evaluation of infection and inflammation are the same for both adults and children. These procedures include (1) either a two- or a three-phase bone scan using technetium-99m methylene diphosphonate; (2) Gallium 67-citrate; (3) in vitro radiolabeled white blood cell imaging (using111 Indium-oxine or99m Technetium hexamethyl-propylene-amine-oxime-labeled white blood cells); and (4) hybrid imaging with18 F-FDG...
March 2018: Seminars in Nuclear Medicine
Apeksha Chaturvedi, Usa Cain, Andrey Rupasov
Acute limp in a child presents a diagnostic conundrum and can result from a variety of causes. The underlying etiology is often referable to the hip, but the spine, abdomen, pelvis, or knee can be alternatively implicated. An adequate clinical history and satisfactory physical examination are often difficult in younger children. Consequently, there is disproportionate reliance on imaging to arrive at the correct diagnosis. The potential for rapid clinical deterioration and long-term sequelae is a risk with some of the conditions presenting with acute hip (septic hip, osteomyelitis)...
February 2018: Seminars in Musculoskeletal Radiology
Marguerite T Parisi, Ramesh S Iyer, A Luana Stanescu
The introduction of diphosphonates in the 1970s revolutionized not only nuclear medicine but musculoskeletal imaging as well, providing functional assessment of entities such as osteomyelitis, trauma, and osseous metastatic disease. Although rarely the first-line imaging modality used today, nuclear medicine procedures continue to play a pivotal role in the evaluation of musculoskeletal diseases in children, providing whole-body assessment of disease involvement. More recently, the introduction of technologies such as single-photon emission computed tomography/computed tomography (SPECT/CT), as well as newer positron-emitting tracers such as 18 fluorine-fluorodeoxyglucose and sodium 18 F-fluorine, particularly when combined with CT (positron emission tomography/CT), have injected new life into the older established techniques and expanded the application of nuclear medicine imaging into new arenas...
February 2018: Seminars in Musculoskeletal Radiology
Benjamin D Welling, Lee S Haruno, Scott B Rosenfeld
BACKGROUND: Septic arthritis is frequently associated with adjacent infections including osteomyelitis and subperiosteal and intramuscular abscesses. While often clinically indiscernible from isolated septic arthritis, the diagnosis of adjacent infections is important in determining the need for additional surgical intervention. MRI has been used as the diagnostic gold standard for assessing adjacent infection. Routine MRI, however, can be resource-intensive and delay surgical treatment...
January 2018: Clinical Orthopaedics and related Research
María T Rosanova, Carla Voto, Susana Carnovale, Nidia Tramonti, Jimena Lema, José L Pinheiro, Adela Isasmendi, Verónica Alvarez, Rosa M Villasboas, Santiago Laborde, Hugo Basílico
INTRODUCTION: Osteomyelitis is uncommon among burn patients. OBJECTIVE: To describe the clinical, microbiological, and evolutionary characteristics of burn children with osteomyelitis hospitalized in a tertiary care facility. METHODS: Retrospective and descriptive study conducted between January 2007 and January 2017. RESULTS: Out of 600 burn children, 12 developed osteomyelitis (incidence: 2%). Eleven patients had a burn caused by direct fire...
February 1, 2018: Archivos Argentinos de Pediatría
M Lorrot, Y Gillet, C Gras Le Guen, E Launay, R Cohen, E Grimprel
Acute hematogenous bone and joint infections (osteomyelitis, septic arthritis, osteoarthritis, and spondylodiscitis) affect more frequently children younger than 5 years of age. Early diagnosis and prompt treatment are needed to limit the risk of complications. Children with suspected bone and joint infections (BJI) should be hospitalized at the beginning of treatment. Surgical drainage is indicated in patients with septic arthritis and in those with periosteal abscess. Staphylococcus aureus is involved in BJIs in children at all ages; Kingella kingae is a very common causative pathogen in children under 4 years of age...
December 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Manish Kiran, Saffwan Mohamed, Ashley Newton, Harvey George, Neeraj Garg, Colin Bruce
AIMS: We present the largest series of paediatric pelvic pyomyositis from a temperate country, analyse the factors influencing long term prognosis and suggest a diagnostic protocol. MATERIALS AND METHOD: We included 41 patients diagnosed with primary paediatric pelvic pyomyositis between 1998 and 2016, in this study with a mean age of 7.5 years. Demographic, clinical, radiological and follow-up data were reviewed. Statistical analysis was performed to analyse the influence of early diagnosis and treatment on the final outcome...
December 30, 2017: International Orthopaedics
Andrea Taddio, Giovanna Ferrara, Antonella Insalaco, Manuela Pardeo, Massimo Gregori, Martina Finetti, Serena Pastore, Alberto Tommasini, Alessandro Ventura, Marco Gattorno
BACKGROUND: Chronic Non-Bacterial Osteomyelitis (CNO) is an inflammatory disorder that primarily affects children. Although underestimated, its incidence is rare. For these reasons, no diagnostic and no therapeutic guidelines exist. The manuscript wants to give some suggestions on how to deal with these patients in the every-day clinical practice. MAIN BODY: CNO is characterized by insidious onset of bone pain with local swelling. Systemic symptoms such as fever, skin involvement and arthritis may be sometimes present...
December 29, 2017: Pediatric Rheumatology Online Journal
Michael A Pfaller, Robert K Flamm, Mariana Castanheira, Helio S Sader, Rodrigo E Mendes
BACKGROUND: Osteomyelitis represents hard-to-treat infections that regularly involve prolonged systemic antibiotic use. Dalbavancin has demonstrated activity against gram-positive isolates and has been considered as a candidate for osteomyelitis therapy in adults and children. This study evaluates the activity of dalbavancin against pathogens isolated from bone and joint infections (BJI). METHODS: 801 S. aureus, 160 coagulase-negative staphylococci (CoNS), 164 β-haemolytic streptococci (BHS), 82 E...
December 22, 2017: International Journal of Antimicrobial Agents
M M Elzohairy
BACKGROUND: Pyomyositis PM is defined as a primary pyogenic infection of the striated skeletal muscle; although it has many dystrophic musculoskeletal complications, it is always misdiagnosed by many orthopedic surgeons. HYPOTHESIS: PM is rare in temperate climates and usually considered to be a tropical disease, until recent times, after globalization, it is possible to occur in the subtropical climate as in our country. MATERIAL AND METHODS: In the present series, the results of 15 children patients with primary pyomyositis have been reviewed...
December 21, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Divyaswathi Citla Sridhar, Ossama M Maher, Nidra I Rodriguez
Deep venous thrombosis (DVT) has been previously reported in children with methicillin-resistant Staphylococcus aureus (MRSA). This study reviews our institutional experience by evaluating characteristics and outcomes of children with DVT and staphylococcal infections. Retrospective clinical data from 16 pediatric patients with DVT and staphylococcal infections over a 5-year period was obtained via medical record abstraction. Sixteen patients with a median age at diagnosis of 8 years were included. The most common infection encountered was osteomyelitis (56%)...
March 2018: Journal of Pediatric Hematology/oncology
A Agarwal, N Gupta, M Mishra, N Agrawal, D Kumar
Clinical series of primary epiphyseal and metaepiphyseal tubercular osteomyelitis are few. The purpose of our study was to retrospectively review the presentation, healing response and functional results of 8 such cases in children. MATERIAL AND METHODS: The patients were evaluated for pain, deformity, range of motion, limb length discrepancy (if any) and recurrence. Serial radiographs of the region were studied to see remineralization, obliteration of radiological lesions, status of physis and remodeling of the growth plate...
December 2016: Acta Orthopaedica Belgica
Patricia Barrios, Federica Badía, Valentina Misa, M Inés Mota, Arací Martínez, Hebert Mariño, Gabriela Algorta, Javier Prego, M Catalina Pírez
BACKGROUND: Salmonella can cause asymptomatic infections, diarrhea, bacteremia and focal infections such as meningitis and osteomyelitis. AIM: To describe clinical and microbiological aspects of infections by Salmonella spp. in children in a pediatric referral hospital: Centro Hospitalario Pereira Rossell, in Montevideo, Uruguay. MATERIALS AND METHODS: Descriptive and retrospective study of 46 patients, from which Salmonella spp was isolated between January 1, 2005 and December 31, 2010...
August 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Elena Tronconi, Angela Miniaci, Michelangelo Baldazzi, Laura Greco, Andrea Pession
Chronic recurrent multifocal osteomyelitis (CRMO) is a rare non-infectious inflammatory disorder with unpredictable clinical course, characterized by acute exacerbations and spontaneous remissions. There are no randomized-controlled trials about treatment options. Non-steroidal anti-inflammatory drugs (NSAID) are the first-line treatment option; glucocorticoids seem to be effective; positive outcomes have been obtained with bisphosphonates. In the last few years successful use of biologic agents like anti-TNF agents has been reported...
November 11, 2017: Rheumatology International
Marcin Karlikowski, Jerzy Sułko
INTRODUCTION: Physeal fractures in children frequently give rise to concerns about the condition of the growth plate. Our observations have proven that the dysfunction of the growth plate is less frequent complication in those cases than misdiagnosed interposition of the periosteum. The aim of this paper is to familiarize the readers with the issue of treatment of physeal fractures of the distal tibia and fibula in the growing skeleton. MATERIALS AND METHODS: We analyzed the group of 75 patients - children and adolescents - with surgically treated physeal fractures of the lower leg...
October 26, 2017: Advances in Medical Sciences
Marieke M van de Meent, Hamid Meshkini, Marta Fiocco, Miranda J M Wetselaar-Glas, Natasha M Appelman-Dijkstra, J P Richard van Merkesteyn
Chronic diffuse sclerosing osteomyelitis (DSO) of the mandible is a rare disease of unknown aetiology. It has been suggested that overuse of the masticatory muscles, tendoperiostitis (TP), is a contributing factor for DSO. Therefore, we tested this hypothesis by treating consecutive children with conservative therapy. All patients were treated with conservative therapy, comprising occlusal splint therapy, physiotherapy, and/or disease counselling. Pain intensity on a visual analogue scale (VAS) and pain frequency in number of days per 3 months were recorded before the start of treatment, and at 3, 6, and 12 months after treatment initiation...
December 2017: Journal of Cranio-maxillo-facial Surgery
Catherine Nowak, Lei Tanaka, Serge Bobin, Jérôme Nevoux
In front of external otitis in spite of a well-conducted treatment, especially in immunodeficient patient, it is always necessary to look for an osteomyelitis of the skull base that requires an urgent parenteral antibiotic treatment of several weeks. Acute otitis media (AOM) is the most common bacterial infection of the child. In children under 2 years with purulent AOM, antibiotic therapy with amoxicilline is systematic for a period of 8-10 days. After 2 years of age and with mild symptoms of AOM, symptomatic treatment may be justified as first-line treatment...
November 2017: La Presse Médicale
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