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Pediatric osteomyelitis

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
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
Brian Y Chan, Kara G Gill, Susan L Rebsamen, Jie C Nguyen
The bone marrow is one of the largest organs in the body and is visible in every magnetic resonance (MR) imaging study. It is composed of a combination of hematopoietic red marrow and fatty yellow marrow, and its composition changes throughout life in response to normal maturation (red to yellow conversion) and stress (yellow to red reconversion). MR imaging is highly sensitive for detection of altered marrow signal intensity, and the T1-weighted spin-echo sequence provides the most robust contrast between yellow marrow and disease...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
David Dornbos, Jocelyn Morin, Joshua R Watson, Jonathan Pindrik
Osteomyelitis of the spine with associated spinal epidural abscess represents an uncommon entity in the pediatric population, requiring prompt evaluation and diagnosis to prevent neurological compromise. Cat scratch disease, caused by the pathogen Bartonella henselae, encompasses a wide spectrum of clinical presentations; however, an association with osteomyelitis and epidural abscess has been reported in only 4 other instances in the literature. The authors report a rare case of multifocal thoracic osteomyelitis with an epidural abscess in a patient with a biopsy-proven pathogen of cat scratch disease...
September 23, 2016: Journal of Neurosurgery. Pediatrics
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
Nathan Batchelder, Tsz-Yin So
Osteomyelitis is a bone infection that requires prolonged antibiotic treatment and potential surgical intervention. If left untreated, acute osteomyelitis can lead to chronic osteomyelitis and overwhelming sepsis. Early treatment is necessary to prevent complications, and the standard of care is progressing to a shorter duration of intravenous (IV) antibiotics and transitioning to oral therapy for the rest of the treatment course. We systematically reviewed the current literature on pediatric patients with acute osteomyelitis to determine when and how to transition to oral antibiotics from a short IV course...
August 8, 2016: World Journal of Clinical Pediatrics
Maria N Gamaletsou, Blandine Rammaert, Marimelle A Bueno, Nikolaos V Sipsas, Brad Moriyama, Dimitrios P Kontoyiannis, Emmanuel Roilides, Valerie Zeller, Saad J Taj-Aldeen, Michael Henry, Vidmantas Petraitis, David W Denning, Olivier Lortholary, Thomas J Walsh
Aspergillus arthritis is a debilitating form of invasive aspergillosis. Little is known about its epidemiology, clinical manifestations, laboratory features, treatment, and prognosis. Cases of Aspergillus arthritis were reviewed in the English literature from 1967 through 2015 for variables of arthritis with Aspergillus spp. recovered from joint and/or adjacent bone, underlying conditions, symptoms, signs, inflammatory biomarkers, diagnostic imaging, management, and outcome. Among 31 evaluable cases, 87% were males and 13% pediatric...
September 8, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Kathleen J Maguire, Norman Y Otsuka
: Shoulder dislocation is relatively uncommon in the younger pediatric population. Because of the relative strength of the surrounding soft tissue structures of the shoulder compared with the proximal humeral physis, subluxation or dislocation resulting from a traumatic event or application of force is rare and instead a proximal humeral physeal injury occurs. Case presentation - We present a 5-year-old male who presented to the office with post-traumatic left shoulder pain for about 1 week...
September 3, 2016: Journal of Pediatric Orthopedics. Part B
Brandon Scott, Brandon Taylor, Joseph R Shung, Prasit Nimityongskul
: Femoral neck and pelvic fractures are rarely encountered in the pediatric population secondary to the resilient nature of the immature skeleton. Both fracture types usually result from high-energy blunt trauma including motor vehicle collisions, motor vehicle-pedestrian accidents, and falls from height. Considerable studies have been published on the natural history, management, and complications of pediatric pelvis and femoral neck fractures. However, few case reports have documented both fracture types in the same patient...
August 4, 2016: Journal of Pediatric Orthopedics. Part B
Alexandre Arkader, Christopher Brusalis, William C Warner, James H Conway, Kenneth Noonan
Musculoskeletal infections, including osteomyelitis, septic arthritis, and pyomyositis, are a substantial cause of morbidity in children and adolescents. The increased virulence of infectious agents and the increased prevalence of antimicrobial-resistant pathogens, particularly methicillin-resistant Staphylococcus aureus, have resulted in a more complicated clinical course for diagnosis and management, which is evidenced by an increased length of hospital stays, incidence of complications, and number of surgical interventions...
September 2016: Journal of the American Academy of Orthopaedic Surgeons
Cristina Calvo, Esmeralda Núñez, Marisol Camacho, Daniel Clemente, Elisa Fernández-Cooke, Rosa Alcobendas, Luis Mayol, Pere Soler, Miren Oscoz, Jesús Saavedra-Lozano
BACKGROUND: Acute osteoarticular infection (OAI) is a potentially severe disease. The aim of this study was to evaluate the etiology, clinical characteristics and therapeutic approach of OAI in children in Spain. METHODS: Medical records from children <14 years with OAI from 25 hospitals between 2008-2012, were reviewed. Confirmed osteomyelitis (OM) and septic arthritis (SA) required a positive bacterial isolate; otherwise, they were considered probable. Probable SA with <40,000 cells/mm3 in joint fluid were not included...
July 22, 2016: Pediatric Infectious Disease Journal
David E Tabor, Li Yu, Hoyin Mok, Christine Tkaczyk, Bret R Sellman, Yuling Wu, Vaheh Oganesyan, Tim Slidel, Hasan Jafri, Michael McCarthy, Patricia Bradford, Mark T Esser
Staphylococcus aureus infections lead to an array of illnesses ranging from mild skin infections to serious diseases, such endocarditis, osteomyelitis, and pneumonia. Alpha-toxin (Hla) is a pore-forming toxin, encoded by the hla gene, that is thought to play a key role in S. aureus pathogenesis. A monoclonal antibody targeting Hla, MEDI4893, is in clinical development for the prevention of S. aureus ventilator-associated pneumonia (VAP). The presence of the hla gene and Hla protein in 994 respiratory isolates collected from patients in 34 countries in Asia, Europe, the United States, Latin America, the Middle East, Africa, and Australia was determined...
September 2016: Antimicrobial Agents and Chemotherapy
A E Osman, M Mubasher, N E ElSheikh, H AlHarthi, M S AlZahrani, N Ahmed, G ElGhazali, B A Bradley, A-S A Fadil
Hematogenous osteomyelitis (HO) is a bone infection wherein bacteria penetrate to the bone through the blood stream. Several single nucleotide polymorphisms (SNPs) have been associated with susceptibility to infectious diseases. In this study, we investigated the contribution of SNPs in interleukin (IL)-1B1 (rs16944), IL1A (rs1800587), IL1B (rs1143634), toll-like receptor (TLR)-2 (rs3804099), TLR4 (rs4986790), TLR4 (rs4986791), IL1R (rs2234650), tumor necrosis factor (TNF)-α (rs1800629), TNF (rs361525), and IL1RN (rs315952) towards the development of HO in Saudi patients and compared to healthy controls...
2016: Genetics and Molecular Research: GMR
Bonnie L Padwa, Kelley Dentino, Caroline D Robson, Sook Bin Woo, Kyle Kurek, Cory M Resnick
PURPOSE: Chronic nonbacterial osteomyelitis (CNO) is a focal sterile inflammatory osteitis in children that most commonly develops in the long bones, but can occur in any bone. The disease course is variable, ranging from acute and self-resolving isolated lesions to chronic recurrent multifocal osteomyelitis (CRMO), which is frequently associated with extraosseous inflammatory disease. The purpose of this study was to present our clinical experience with CNO of the mandible in children...
May 26, 2016: Journal of Oral and Maxillofacial Surgery
Megan E Mignemi, Michael A Benvenuti, Thomas J An, Jeffrey E Martus, Gregory A Mencio, Stephen A Lovejoy, Lawson A Copley, Derek J Williams, Isaac P Thomsen, Jonathan G Schoenecker
BACKGROUND: Musculoskeletal infections (MSKIs) are a common cause of pediatric hospitalization. Children affected by MSKI have highly variable hospital courses, which seem to depend on infection severity. Early stratification of infection severity would therefore help to maximize resource utilization and improve patient care. Currently, MSKIs are classified according to primary diagnoses such as osteomyelitis, pyomyositis, etc. These diagnoses, however, do not often occur in isolation and may differ widely in severity...
June 13, 2016: Journal of Pediatric Orthopedics
Deirdre D Ryan
A variety of traumatic and infectious processes can cause acute onset of hip pain and difficulty walking. Without a history of trauma, a common cause is transient (or "toxic") synovitis, but serious infectious causes, such as septic arthritis of the hip or osteomyelitis, must be ruled out. Differentiating between septic arthritis of the hip (a true emergency) and transient synovitis of the hip (a much more benign inflammatory process) can be difficult. The Kocher criteria have proven to be helpful in making the distinction between these two conditions, and they are reviewed in this article...
June 1, 2016: Pediatric Annals
Noelle S B Whyte, Robert J Bielski
This article discusses the most common organisms associated with acute hematogenous osteomyelitis in children. Magnetic resonance imaging is extremely important in evaluating the extent of the disease process. Osteomyelitis due to methicillin-resistant Staphylococcus aureus can be extremely difficult to treat and eradicate. It spreads quickly and causes local tissue necrosis. It is also associated with other serious sequelae such as deep venous thrombosis and septic pulmonary emboli. A multidisciplinary approach is needed to treat these infections...
June 1, 2016: Pediatric Annals
Cole M Erickson, Paul K Sue, Kyana Stewart, Michelle I Thomas, Eduardo A Lindsay, ChanHee Jo, Lawson A B Copley
BACKGROUND: Children with musculoskeletal infection in methicillin-resistant Staphylococcus aureus (MRSA) prevalent communities are often treated with oral clindamycin. Current guidelines recommend approximately 40 mg/kg/d for MRSA infections. This study investigates the clinical practice of using 30 mg/kg/d of clindamycin as an alternative for outpatient dosing. METHODS: Children with musculoskeletal infection treated with outpatient clindamycin from 2009 to 2014 were studied by retrospective review...
October 2016: Pediatric Infectious Disease Journal
Brad Stone, Matthew Street, Warren Leigh, Haemish Crawford
BACKGROUND: Osteomyelitis shows a strong predilection for the tibia in the pediatric population and is a significant source of complications. The purpose of this article is to retrospectively review a large series of pediatric patients with tibial osteomyelitis. We compare our experience with that in the literature to determine any factors that may aid diagnosis and/or improve treatment outcomes. METHODS: A 10-year retrospective review was performed of clinical records of all cases of pediatric tibial osteomyelitis managed at the 2 children's orthopaedic departments in the Auckland region...
July 2016: Journal of Pediatric Orthopedics
Luca Castellazzi, Marco Mantero, Susanna Esposito
Acute osteomyelitis and septic arthritis are two infections whose frequencies are increasing in pediatric patients. Acute osteomyelitis and septic arthritis need to be carefully assessed, diagnosed, and treated to avoid devastating sequelae. Traditionally, the treatment of acute osteoarticular infection in pediatrics was based on prolonged intravenous anti-infective therapy. However, results from clinical trials have suggested that in uncomplicated cases, a short course of a few days of parenteral antibiotics followed by oral therapy is safe and effective...
2016: International Journal of Molecular Sciences
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