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Pediatric osteomyelitis

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https://www.readbyqxmd.com/read/29782414/osteomyelitis-a-context-for-wound-management
#1
Mary E Groll, Timothy Woods, Richard Salcido
GENERAL PURPOSE: To provide an overview of osteomyelitis. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, you should be able to:1. Distinguish the pathogenesis of osteomyelitis in children and adults.2. Identify practical considerations for diagnosis and evidence-based treatment of osteomyelitis...
June 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29780794/pediatric-scurvy-when-contemporary-eating-habits-bring-back-the-past
#2
Alice Brambilla, Cristina Pizza, Donatella Lasagni, Lucia Lachina, Massimo Resti, Sandra Trapani
Vitamin C deficiency is anecdotal in developed countries, mainly associated with underling clinical morbidities as autism or neurological impairment. Chronic insufficient dietary supply is responsible for vascular fragility and impaired bone formation, resulting in gingival bleeding, petechial lesions, articular and bone pain or limb swelling. Children may present anorexia, irritability, failure to thrive, limping or refusal to walk. Accordingly, pediatric scurvy is frequently misdiagnosed with osteomyelitis, septic arthritis, bone and soft tissue tumor, leukemia, bleeding disorders, and rheumatologic conditions...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29776891/chronic-recurrent-multifocal-osteomyelitis-in-pediatrics-a-diagnostic-challenge
#3
N Roig-Abraham, M Méndez-Hernández, M Martínez-Morillo
Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory disease that presents with aseptic bone inflammation and can be accompanied by multisystemic symptoms. We present the case of a 14-year-old male with a 2-week history of pain located at the tibial metaphysis and fever. X-ray revealed a lytic lesion in the tibial metaphysis. MRI revealed an intramedullary bone lesion with perilesional bone oedema. CT-guided biopsy discounted malignancy and microbiological cultures were negative. The patient's symptoms and fever worsened after the biopsy; therefore antibiotherapy was commenced for a suspected superinfection...
May 15, 2018: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29742530/rapid-decompensation-to-systemic-inflammatory-response-syndrome-in-children-with-osteomyelitis-a-report-of-three-cases
#4
Barbara Minkowitz, Jennifer R Ristic, Lauren Murphy, Todd Pierce, Elizabeth Baorto
CASE: We present 3 pediatric cases of osteomyelitis with delayed diagnosis, which resulted in systemic inflammatory response syndrome (SIRS) and complicated hospital stays. CONCLUSION: These 3 cases illustrate that early treatment of osteomyelitis is imperative in order to avoid fatal complications, which can occur with SIRS. Subtle signs and symptoms should not be dismissed. Patients with fever, pain, and no history of trauma should be scrutinized.
May 9, 2018: JBJS Case Connector
https://www.readbyqxmd.com/read/29727410/improved-diagnosis-and-treatment-of-bone-and-joint-infections-using-an-evidence-based-treatment-guideline
#5
Rachel D Quick, John Williams, Marisol Fernandez, Hilton Gottschalk, Peter Cosgrove, Kyle Kahlden, Kathryn Merkel, Lynn Thoreson, Patrick Boswell, Sarmistha B Hauger
BACKGROUND: Our institution created a multidisciplinary guideline for treatment of acute hematogenous osteomyelitis (AHO) and septic arthritis (SA) in response to updates in evidence-based literature in the field and existing provider variability in treatment. This guideline aims to improve the care of these patients by standardizing diagnosis and treatment and incorporating up to date evidence-based research into practice. The primary objective of this study is to compare cases before versus after the implementation of the guideline to determine concrete effects the guideline has had in the care of patients with AHO and SA...
May 2, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29721598/current-utilization-and-procedural-practices-in-pediatric-whole-body-mri
#6
Gary R Schooler, Joseph T Davis, Heike E Daldrup-Link, Donald P Frush
BACKGROUND: Whole-body magnetic resonance imaging (MRI) is an evolving and increasingly powerful imaging tool with a variety of applications in the pediatric patient population. Variability exists among radiology practices in how this MRI tool is used and how it performed. OBJECTIVE: Our objective was to gain an improved understanding of technical and utilization practices in pediatric whole-body MRI across North America by exploring indications for exam performance, determining referral patterns, and assessing technical protocols and procedures...
May 2, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29657465/do-demographic-and-perioperative-parameters-really-affect-the-final-outcomes-of-pediatric-femur-shaft-fractures-managed-by-elastic-nails-a-prospective-study
#7
Abhinandhan Reddy, Narendran Pushpasekaran, Jitendra Singh, Gokul Chand Verma, Sathyamurthy Palanisamy
Objective: Pediatric femoral shaft fractures are more commonly treated with intramedullary titanium elastic nail system (TENS). Adhering to the principles, most studies had supported excellent results with this instrumentation and attributed the variation in age, weight, immobilization protocols, technical factors like fracture pattern, reduction and complications as reasons to poor outcomes in their individual studies. Hence, we wanted to identify the potential demographic and perioperative parameters that could affect the final outcomes in this cohort...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29652766/-chronic-recurrent-multifocal-osteomyelitis-of-the-mandible-a-diagnostic-challenge
#8
Liliana Camison, Rick S Mai, Jesse A Goldstein, Bernard J Costello, Kathryn S Torok, Joseph E Losee
Chronic recurrent multifocal osteomyelitis (CRMO) is a rare autoinflammatory bone disorder of children and adolescents characterized by mono- or multi-focal inflammatory bone lesions that are culture-negative on biopsy, associated with periods of exacerbation and resolution that can last over several months to years. Although it is predominantly a disease of long bones and the spine, craniofacial involvement is not uncommon, affecting the mandible in up to a fifth of cases. Similarities with other etiologies of osteitis in clinical presentation and imaging, as well as the lack of specific symptoms or laboratory tests, make CRMO mainly a diagnosis of exclusion...
March 28, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29626010/comparison-of-empiric-antibiotics-for-acute-osteomyelitis-in-children
#9
Sarah McBride, Cary Thurm, Ramikan Gouripeddi, Bryan Stone, Phil Jaggard, Samir S Shah, Joel S Tieder, Ryan Butcher, Jason Weiser, Matt Hall, Ron Keren, Christopher P Landrigan
OBJECTIVES: Broad-spectrum antibiotics are commonly used for the empiric treatment of acute hematogenous osteomyelitis and often target methicillin-resistant Staphylococcus aureus (MRSA) with medication-associated risk and unknown treatment benefit. We aimed to compare clinical outcomes among patients with osteomyelitis who did and did not receive initial antibiotics used to target MRSA. METHODS: A retrospective cohort study of 974 hospitalized children 2 to 18 years old using the Pediatric Health Information System database, augmented with clinical data...
April 6, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29620720/brodie-s-abscess-in-children-a-ten-year-single-institution-retrospective-review
#10
Catherine E Foster, Margaret Taylor, Erica K Schallert, Scott Rosenfeld, Katherine Y King
Brodie's abscess is a subacute hematogenous osteomyelitis characterized by intraosseous abscess formation. Treatment recommendations and clinical outcomes for this unusual infection are not well-established. We report fifteen cases of Brodie's abscess in a ten-year retrospective review of pediatric patients at Texas Children's Hospital and describe their clinical presentation and outcomes.
March 31, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29600201/femoral-head-stress-fracture-in-children-a-case-report
#11
Mourad Zaraa, Heithem Sahli, Imene Yeddes, Sabri Mahjoub, Mondher Mbarek
Introduction: The stress fracture of the femoral head rarely occurs; but, it is generally encountered in case of bone insufficiency, and it is exceptional in younger individuals. The main differential diagnosis may include several diseases, namely, slipped upper femoral epiphysis, septic arthritis, osteomyelitis, and Perthes' disease. Bone scintigraphy is very sensitive but lacks specificity. Nowadays, the magnetic resonance imaging (MRI) is the gold standard for an accurate diagnosis...
November 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29595537/chronic-osteomyelitis-caused-by-haemophilus-parainfluenzae-a-case-report
#12
Vignesh Ramachandran, Lee S Haruno, Theodora S Browne, Laila E Woc-Colburn, Scott B Rosenfeld, Vinitha R Shenava
CASE: A 14-year-old boy presented with a pathologic fracture of the distal aspect of the tibia and a remote history of a dog bite near the injury site. Imaging studies, biopsy, and presentation corroborated the diagnosis of chronic osteomyelitis. Multiple diagnostic methods were negative until an open biopsy identified Haemophilus parainfluenzae, a fastidious oropharyngeal bacterium, with polymerase chain reaction analysis. The patient underwent extensive debridement, placement of external fixation, and a year-long antibiotic therapy regimen...
January 2018: JBJS Case Connector
https://www.readbyqxmd.com/read/29570590/osteoarticular-infections-following-open-or-penetrating-trauma-in-children-in-the-post-community-acquired-methicillin-resistant-staphylococcus-aureus-era-the-impact-of-enterobacter-cloacae
#13
J Chase McNeil, Jesus G Vallejo, Kristina G Hulten, Sheldon L Kaplan
BACKGROUND: Most cases of pediatric osteoarticular infections (OAI) are hematogenous in nature and caused by Staphylococcus aureus. OAI in children can also occur through direct inoculation of microorganisms secondary to penetrating or open trauma. No studies in the US have evaluated the microbiology or outcomes of trauma-related OAI (TROAI) in children in the era of community-acquired MRSA (CA-MRSA). METHODS: Cases were identified from the inpatient infectious diseases consultation database at Texas Children's Hospital from Jan 2011-Dec 2016...
March 21, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29569505/risk-factors-associated-with-complications-sequelae-of-acute-and-subacute-haematogenous-osteomyelitis-an-italian-multicenter-study
#14
Elena Chiappini, Andrzej Krzysztofiak, Elena Bozzola, Clara Gabiano, Susanna Esposito, Andrea Lo Vecchio, Maria Rita Govoni, Cristina Vallongo, Icilio Dodi, Elio Castagnola, Nadia Rossi, Piero Valentini, Fabio Cardinale, Filippo Salvini, Gianni Bona, Grazia Bossi, Alma Nunzia Olivieri, Fiorella Russo, Emilio Fossali, Gabriella Bottone, Marta Dellepiane, Maurizio de Martino, Alberto Villani, Luisa Galli
BACKGROUND: Acute/subacute haematogenous osteomyelitis (AHOM/SAHOM) are potentially devastating diseases. Updated information about the epidemiology, management and outcome of AHOM/SAHOM is needed to minimize the risk of complications and sequelae. METHODS: A multicenter study was performed to evaluate retrospectively the management and outcome of AHOM/SAHOM in Italy. Data from children aged>1 month, and hospitalized between 2010 and 2016, in 19 pediatric centers, were analyzed...
March 23, 2018: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/29552433/pediatric-primary-tuberculous-osteomyelitis-of-the-mandible-mimicking-parotitis
#15
Raja Kalaiarasi, Chellappa Vijayakumar, Ramalingam Archana, Ramalingam Natarajan
Tuberculosis (TB) is a worldwide public health problem; however, primary tuberculous osteomyelitis involving the mandible is extremely rare. Here, we report a 14-year-old boy who presented with a recurrent, generalized swelling of the cheek in the right side, mimicking parotitis. Fine needle aspiration cytology (FNAC) from the swelling was inconclusive. Contrast-enhanced computed tomography (CECT) of the head and neck revealed an osteolytic lesion of the mandible with a surrounding abscess. An intraoral incisional biopsy of the tissue showed a granulomatous lesion...
January 15, 2018: Curēus
https://www.readbyqxmd.com/read/29509649/presentation-and-investigation-of-pediatric-bone-and-joint-infections-in-the-pediatric-emergency-department
#16
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
https://www.readbyqxmd.com/read/29462119/comparison-of-methicillin-resistant-versus-susceptible-staphylococcus-aureus-pediatric-osteomyelitis
#17
William T Davis, Shawn R Gilbert
BACKGROUND: The incidence of methicillin-resistant Staphylococcus aureus (MRSA) pediatric osteomyelitis has risen and been associated with a more severe clinical course than methicillin-susceptible Staphylococcus aureus (MSSA) infections. National databases have been underutilized to describe these trends. We compared demographics, clinical course, and outcomes for patients with MRSA versus MSSA osteomyelitis. METHODS: We queried the 2009 and 2012 Healthcare Cost and Utilization Project Kids Inpatient Database for discharge records with diagnosis codes for osteomyelitis and S...
May 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29452618/radionuclide-imaging-of-infection-and-inflammation-in-children-a-review
#18
REVIEW
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 (using 111 Indium-oxine or 99m Technetium hexamethyl-propylene-amine-oxime-labeled white blood cells); and (4) hybrid imaging with 18 F-FDG...
March 2018: Seminars in Nuclear Medicine
https://www.readbyqxmd.com/read/29409071/nuclear-medicine-applications-in-pediatric-musculoskeletal-diseases-the-added-value-of-hybrid-imaging
#19
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
https://www.readbyqxmd.com/read/29389760/validating-an-algorithm-to-predict-adjacent-musculoskeletal-infections-in-pediatric-patients-with-septic-arthritis
#20
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
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