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Osteomyelitis in childrens

Miguel Flores, Anthony Caram, Edward Derrick, John D Reith, Laura Bancroft, Kurt Scherer
Ewing sarcoma (ES) is a primary malignant bone tumor which most commonly arises in children and young adults. The common clinical presentation with ES includes nighttime pain or pain related to activity, though patients may also present with a combination of localized swelling, a palpable mass, pathologic fracture, and constitutional symptoms. Clinical diagnosis may be delayed when a patient presents with clinical or imaging findings that overlap with non-malignant etiologies, such as fibrous dysplasia (FD) or osteomyelitis...
September 18, 2016: Curēus
A Lemoine, F Baudin, R Vialle, E Grimprel
INTRODUCTION: The prognosis of osteoarticular infections has improved over the past 20 years but it still remains potentially severe. The treatment of these infections has been simplified and shortened. In 2008, the Pediatric Infectious Disease Group (GPIP) established new therapeutic guidelines in order to standardize treatment in France. The aim of this study is to analyze practices in a Parisian hospital and assess the efficacy of this treatment in short and medium terms. MATERIALS AND METHODS: This retrospective study focused on patients older than 3 months, without comorbidities, who were hospitalized for an acute osteoarticular infection in 2012 at Trousseau Hospital (Paris), with a follow-up of at least 4 weeks...
October 10, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Alexander G Athey, Megan E Mignemi, William T Gheen, Eduardo A Lindsay, Chan-Hee Jo, Lawson A Copley
BACKGROUND: Children with osteomyelitis demonstrate a wide spectrum of illness. Objective measurement of severity is important to guide resource allocation and treatment decisions, particularly for children with advanced illness. The purpose of this study is to validate and improve a previously published severity of illness scoring system for children with acute hematogenous osteomyelitis (AHO). METHODS: Children with AHO were prospectively studied during evaluation and treatment by a multidisciplinary team who provided care according to evidence-based guidelines to reduce variation...
October 12, 2016: Journal of Pediatric Orthopedics
A Schnabel, U Range, G Hahn, T Siepmann, R Berner, C M Hedrich
Historically, osteomyelitis was considered an infectious disorder. More recently, inflammatory mechanisms were recognized causing a significant proportion of pediatric osteomyelitis. This study was to compare characteristics of children with chronic non-bacterial (CNO) and bacterial osteomyelitis (BOM). A chart review of osteomyelitis patients from the departments of pediatrics, pediatric surgery, orthopedic surgery, and oral and maxillofacial surgery was conducted in a tertiary referral center, covering the years 2004-2014...
October 11, 2016: Rheumatology International
Jeffrey B Kaplan, Vandana Sampathkumar, Meriem Bendaoud, Alexander K Giannakakis, Edward T Lally, Nataliya V Balashova
The Gram-negative bacterium Kingella kingae is part of the normal oropharyngeal mucosal flora of children under four years old. K. kingae can enter the submucosa and cause infections of the skeletal system in children including septic arthritis and osteomyelitis. The organism is also associated with infective endocarditis in children and adults. Although biofilm formation has been coupled with pharyngeal colonization, osteoarticular infections, and infective endocarditis, no studies have investigated biofilm formation in K...
October 7, 2016: Molecular Oral Microbiology
R Siva Kumar, Prahalad K Singhi, M Chidambaram, Kiran Kakkandki
INTRODUCTION: Patella osteomyelitis is a rare entity in adults. Most often it is seen in children of five to twelve years of age because of its unique ossification and vascularity. Immuno compromised states like HIV, tuberculosis, intravenous drug abuse and trauma have been predisposing factors for adult patellar osteomyelitis. We report two cases of patellar osteomyelitis in adult diabetic women with uncontrolled glycemic levels and having no previous history of any trauma or systemic infection...
April 2016: Journal of Orthopaedic Case Reports
T Tricard, L Bund, A Alhefzi, J-P Lemoine, L Schneider, C Karger, J-M Clavert, P Gicquel
: Eikenella corrodens (EC) is a human commensal microorganism of the mouth flora. This bacterium is rarely reported in bone and joint infections in children, but the consequences on the joint function can be devastating and irreversible. We report the case of septic arthritis of the hip following an oral wound in a 12-year-old boy. The progression of the condition was favorable with no complications or pain observed after antibiotic treatment. Clinical and radiological examinations showed a satisfactory outcome at 6 months with no sign of recurrence or complication (growth disorder)...
September 20, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Federico Canavese, Marco Corradin, Ahmad Khan, Mounira Mansour, Marie Rousset, Antoine Samba
PURPOSE: Chronic osteomyelitis and infected nonunion are relatively rare conditions in pediatric patients and are more frequently seen in developing countries. Although relatively rare, they are medically and surgically challenging. Here we report a novel surgical technique used to manage five patients with chronic osteomyelitis of long bones. METHODS: Five skeletally immature patients with chronic osteomyelitis and infected nonunion of the long bones were treated surgically between 2010 and 2014 by a combination of resection of necrotic infected bone, debridement of surrounding soft tissue, and application of antibiotic-laden cement spacer inducing periosteal membrane before final bone reconstruction...
September 19, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
C Thévenin-Lemoine, J Vial, J L Labbé, B Lepage, B Ilharreborde, F Accadbled
INTRODUCTION: The classic pathophysiology of acute osteomyelitis in children described by Trueta has a metaphyseal infection as the starting point. This hypothesis was recently brought into question by Labbé's study, which suggested a periosteal origin. Thus, we wanted to study this disease's pathophysiology through early MRI examinations and to look for prognostic factors based on abnormal findings. MATERIAL AND METHODS: This was a prospective, multicentre study that included cases of long bone osteomyelitis in children who underwent an MRI examination within 7days of the start of symptoms and within 24hours of the initiation of antibiotic therapy...
September 15, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
M Le Hanneur, C Vidal, C Mallet, K Mazda, B Ilharreborde
A 32-month-old boy presented with febrile limping that had developed over 6days, associated with right lumbosacral inflammatory swelling. Magnetic resonance imaging (MRI) showed joint effusion of the right L5-S1 zygapophyseal joint, complicated by destructive osteomyelitis of the L5 articular process and paraspinal abscess. Surgery was decided to evacuate the fluid accumulation and rule out differential diagnoses. The diagnosis of septic arthritis of the facet joint was confirmed intraoperatively; real-time quantitative PCR analysis identified Kingella kingae...
September 14, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Eliz Kilich, Reena Dwivedi, Shelley Segal, Sandeep Jayawant, Manish Sadarangani
We describe the youngest case to date of a 2 year old child who developed central skull base osteomyelitis (SBO) initially presenting with a fever, vomiting and sore throat. An extremely rare complication of mastoiditis following otitis media in children is SBO which can present with non-specific symptoms. This report describes the first case of symptomatic ischaemic stroke secondary to SBO in an immunocompetent child. We review the literature of the management and the potential cerebrovascular complications of central SBO in children secondary to otolaryngological infection...
October 2016: International Journal of Pediatric Otorhinolaryngology
M A Shahin, M I Sultan, M J Alam, A Saeed, A K Azad, M R Choudhury
Cystic tuberculosis of the bone is a rare form of tuberculosis (TB). The condition presents like Juvenile idiopathic arthritis (JIA) of children. In children, the lesions symmetrically involve the peripheral skeleton, which are less sclerotic than adults. A case report is presented here where the patient presented with i) the extensive involvement of bones with cystic lesion, ii) Hand & feet involvement with multiple bony exostosis iii) Synovial swelling of multiple joints and 4) fever for 6 months. Swelling of the joints was disproportionately greater than pain...
July 2016: Mymensingh Medical Journal: MMJ
Ana M Silva, Lauwence A Schmalbach
Psoas abscess is a common disease in children. It can have a nonspecific clinical presentation, insidious onset and sometimes fever. The most common type in children is the primary one; however, it can sometimes be of secondary origin and associated with severe infections such as osteomyelitis so a high index of suspicion is required to detect and treat it promptly. We present an unusual case of psoas abscess with infiltration of the vertebral body of L2 in a 14 year old male patient previously healthy with no history of trauma or fever on admission...
October 1, 2016: Archivos Argentinos de Pediatría
Jedidiah E Schlung, Tracey P Bastrom, Joanna H Roocroft, Peter O Newton, Scott J Mubarak, Vidyadhar V Upasani
BACKGROUND: The role of femoral aspiration (FA) in the treatment of septic arthritis of the hip is controversial. The purpose of this study was to determine if FA conducted concomitantly with irrigation and debridement (I&D) of the septic hip aids in microorganism and osteomyelitis identification and alters the treatment plan, or if the risks of the procedure outweigh its potential benefit. We also compare preoperative magnetic resonance imaging (MRI) with FA for diagnosis of osteomyelitis cooccurring with septic arthritis...
September 3, 2016: Journal of Pediatric Orthopedics
Joonhyoung Park, Hoon Myoung
In prolonged chronic osteomyelitis, chronic inflammation and low-grade infections can result in new periosteal bone formation. Chronic osteomyelitis with proliferative periostitis (traditionally termed Garré's sclerosing osteomyelitis) mainly affects children and young adults. Here, we present two rare cases of an 11-year-old and a 12-year-old patient with suppurative chronic osteomyelitis with proliferative periostitis without any definitive infection source, such as dental caries or periodontitis. The source of infection was likely to be related to the development of a lower right third molar germ with follicular space widening...
August 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
Noa Safra, Peta L Hitchens, Emanual Maverakis, Anupam Mitra, Courtney Korff, Eric Johnson, Amir Kol, Michael J Bannasch, Niels C Pedersen, Danika L Bannasch
Metaphyseal osteopathy (MO) (hypertrophic osteodystrophy) is a developmental disorder of unexplained etiology affecting dogs during rapid growth. Affected dogs experience relapsing episodes of lytic/sclerotic metaphyseal lesions and systemic inflammation. MO is rare in the general dog population; however, some breeds (Weimaraner, Great Dane and Irish Setter) have a much higher incidence, supporting a hereditary etiology. Autoinflammatory childhood disorders of parallel presentation such as chronic recurrent multifocal osteomyelitis (CRMO), and deficiency of interleukin-1 receptor antagonist (DIRA), involve impaired innate immunity pathways and aberrant cytokine production...
October 15, 2016: Veterinary Immunology and Immunopathology
Matthias Christian Wurm, Ines Brecht, Michael Lell, Kathrin Brunner, Konstantinos Theodorou Mitsimponas, Martin Chada, Julia Jahn, Friedrich-Wilhelm Neukam, Cornelius von Wilmowsky
BACKGROUND: Chronic recurrent multifocal osteomyelitis (CRMO) is a rare acquired inflammatory skeletal disorder of unknown origin. CRMO was first described by Gideon in 1972 and mainly affects children and young adults of female gender. The CRMO is part of the clinical picture of non-bacterial Osteomyelitis (NBO) and typically presents a relapsing recurring course with both remission and spontaneous exacerbation. CRMO is typically encountered in the limbs and the metaphysis of long bones in particular...
2016: BMC Oral Health
Xiangshui Sun, Yue Lou, Xiaodong Wang
Iliac bone destruction in children is uncommon and presents various imaging features. Correct diagnosis based on clinical and imaging features is difficult. This research aimed to retrospectively explore the clinical features, imaging, and histopathological diagnosis of children with iliac bone destruction. A total of 22 children with iliac bone destruction were enrolled in this retrospective analysis from two children's hospitals during July 2007 to April 2015. Clinical features, imaging, and histopathological findings were analysed...
2016: BioMed Research International
M R Roderick, R Shah, V Rogers, A Finn, A V Ramanan
BACKGROUND: Chronic recurrent multifocal osteomyelitis (CRMO) is a little known inflammatory bone disease occurring primarily in children and adolescents. Delays in referral and diagnosis may lead to prolonged courses of antibiotics with in-patient care, unnecessary radiation exposure from multiple plain radiographs or bone scans and repeated surgery including bone biopsies. Children (aged < 18 years) diagnosed with CRMO between January 2005 and December 2012, reviewed at Bristol Royal Hospital for Children were included and all available data collected...
2016: Pediatric Rheumatology Online Journal
A Cc Chou, A Mahadev
PURPOSE: To review the records of 24 paediatric patients treated for acute bacterial osteomyelitis. METHODS: Records of 14 male and 10 female paediatric patients (mean age, 9.4 years) who underwent medical treatment alone (n=3) or combined with surgery (n=21) for acute bacterial osteomyelitis were reviewed. Medical treatment included use of antibiotics and supportive care. Surgery was indicated when the largest dimension of fluid collection was >1 cm. RESULTS: Of the 24 patients, Staphylococcus aureus was isolated in 18, group-D salmonella in 3, and no organism in 3...
August 2016: Journal of Orthopaedic Surgery
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