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Pediatric joint infection

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
Gianfranco Frojo, Kashyap Komarraju Tadisina, Vilaas Shetty, Alexander Y Lin
Infection of the temporomandibular joint (TMJ) is a rare pediatric condition resulting from the introduction of pathogens into the joint by hematogenous seeding, local extension, or trauma. Early recognition of the typical signs and symptoms including fever, trismus, preauricular swelling, and TMJ region tenderness are critical in order to initiate further evaluation and prevent feared complications of fibrosis, ankylosis, abnormal facial structure, or persistence of symptoms. Contrast-enhanced computed tomography with ancillary laboratory analysis including erythrocyte sedimentation rate, C-reactive protein, and white blood cell count are beneficial in confirming the suspected diagnosis and monitoring response to therapy...
January 2018: Plastic and Reconstructive Surgery. Global Open
Anne Filleron, Sarah Beauregard-Birba, Thibault Mura, Fabien Aujoulat, Anne Laure Michon, Michel Rodière, Tu Anh Tran, Eric Jeziorski, Hélène Marchandin
BACKGROUND: In children, surveys on Staphylococcus aureus have focused on specific infections, situations or strains but no study has so far given an overview on S. aureus isolation without any selection. Here, we describe the overall bacteriological and clinical characteristics of S. aureus isolation in children, with a special focus on isolates harbouring tst, sea, and/or luk-PV genes, respectively, encoding the three clinically relevant toxins: toxic shock syndrome toxin-1, enterotoxin A and Panton-Valentine leukocidin...
February 13, 2018: World Journal of Pediatrics: WJP
Chao-Feng Zhao, Quan-Yang Gao, Tian-Jian Zhang, Lu-Li Han, Jun-Feng Zhao, Gang Chen, Yu Cui
OBJECTIVE: To explore the clinical effect of closed reduction and minimally invasive treatment of humeral shaft fractures in children. METHODS: From July 2011 to April 2015, 39 cases of pediatric humeral shaft fractures were treated by closed reduction and external fixation, including 27 males and 12 females with a mean age of 8.6 years old ranging from 3 to 14 years old. Time from injury to the treatment was 2 h to 7 days with an average of 2.7 days. There were 6 cases of upper fracture, 21 cases of middle fracture and 12 cases of lower fracture...
July 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Yangmei Jiang, Yuanjin Huang, Bin Ye, Yunfeng Li, Songsong Zhu
This retrospective study described the authors' experience in the treatment of temporomandibular joint (TMJ) ankylosis with dentofacial deformities in 18 pediatric patients during a 4-year period. These patients underwent different types of arthroplasty with condylar reconstruction, simultaneously with treatment of dentofacial deformities. Re-ankylosis was confirmed if maximal incisal opening (MIO) was <20 mm. Clinical outcomes were evaluated in terms of oral function, radiography, and medical photography...
January 19, 2018: Journal of Craniofacial Surgery
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
Nina Droz, Vincent Enouf, Philippe Bidet, Damir Mohamed, Sylvie Behillil, Anne-Laure Simon, Manon Bachy, Marion Caseris, Stéphane Bonacorsi, Romain Basmaci
OBJECTIVE: To determine whether the seasonal distribution of Kingella kingae osteoarticular infections is similar to that of common respiratory viruses. STUDY DESIGN: Between October 2009 and September 2016, we extracted the results of K kingae-specific real-time polymerase chain reaction analyses performed for bone or joint specimens in patients from 2 pediatric tertiary care centers in Paris. We used data of respiratory virus detection from the Réseau National des Laboratoires network with coordination with the National Influenza Center of France...
January 2018: Journal of Pediatrics
Ann Heble, Melanie D Everitt, Jane Gralla, Shelley D Miyamoto, Michael Lahart, Jennifer Eshelman
mTOR inhibitors have been associated with SWC when used in the perioperative period. Limited literature is available to guide providers in managing chronic mTOR inhibitor use in the perioperative period, especially in the pediatric setting. The primary aim of this study was to describe the prevalence of SWC with mTOR inhibitor continuation during the perioperative period for major surgeries. Heart transplant recipients ≤25 years old at the time of primary heart transplant receiving sirolimus maintenance therapy during a surgical procedure and within the study period were included...
February 2018: Pediatric Transplantation
Carmelle Tsai, Jennifer Deramo, Xiaofan Shen, Kathleen Vandiver, Vineeta Mittal
A 5-year-old previously healthy child presented with right-sided otalgia, right facial and temporal swelling, and right jaw pain in the setting of 6 days of low-grade fever. The child had no trauma, vomiting, or prior dental treatments. On physical examination, the patient had facial swelling, erythema, and tenderness over the right temporal region along with trismus, as well as pain on palpation of the right temporomandibular joint (TMJ). A computed tomography scan revealed otitis media, Luc's abscess, and TMJ septic arthritis requiring surgical drainage and intravenous antibiotics...
November 20, 2017: Pediatric Emergency Care
Maria Escobar, Albaro J Nieto, Sara Loaiza-Osorio, Juan S Barona, Fernando Rosso
In 2015 in Colombia, 60 pregnant women were hospitalized with chikungunya virus infections confirmed by reverse transcription PCR. Nine of these women required admission to the intensive care unit because of sepsis with hypoperfusion and organ dysfunction; these women met the criteria for severe acute maternal morbidity. No deaths occurred. Fifteen women delivered during acute infection; some received tocolytics to delay delivery until after the febrile episode and prevent possible vertical transmission. As recommended by a pediatric neonatologist, 12 neonates were hospitalized to rule out vertical transmission; no clinical findings suggestive of neonatal chikungunya virus infection were observed...
November 2017: Emerging Infectious Diseases
Charles Nathan Nessle, Allison K Black, Justin Farge, Victoria A Statler
A 5-month-old previously healthy female presented with a one-week history of fever and increased fussiness. Her presentation revealed an ill-appearing infant with an exam and cerebrospinal fluid (CSF) studies concerning bacterial meningitis; CSF cultures grew Pasteurella multocida. Additionally, brain magnetic resonance imaging (MRI) demonstrated cervical osteomyelitis. Despite multiple days of antibiotic therapy, she remained febrile with continued pain; MRI showed oligoarticular effusions, and aspiration of these joints yielded bloody aspirates...
October 16, 2017: Children
Nicolas V Vardiabasis, John A Schlechter
BACKGROUND: Children who present to the emergency department (ED) with complaint of fever and new-onset joint or extremity pain can be a diagnostic dilemma for many emergency and consulting physicians. OBJECTIVES: The purpose of our study was to identify the etiologies of pediatric fever and extremity pain presenting to a tertiary care pediatric ED and to define factors that were associated with advanced imaging, admission, and surgical intervention. METHODS: The electronic medical records of children presenting to our institution's pediatric ED with fever and extremity pain were retrospectively reviewed...
September 2017: Journal of Emergency Medicine
Carlos Zuníno, Alejandra Vomero, Soledad Pandolfo, Claudia Gutiérrez, Gabriela Algorta, M Catalina Pírez, Gustavo Giachetto
BACKGROUND: The most frequent osteoarticular infections (OAI) etiological agent is Staphylococcus aureus. The prevalence of other microorganisms has changed after the introduction of new vaccines. AIM: To describe the etiology and evolution of the OAIs in children hospitalized in Pediatric Hospital Pereira Rossell between 2009 and 2015. PATIENTS AND METHODS: Joint fluid and bone puncture studies of hospitalized children suspected of OAI. Epidemiological characteristics, isolated microorganisms, complementary tests, initial treatment, complications, and days of hospitalization were analyzed...
June 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Edward S Kim, Suanna S Bruinooge, Samantha Roberts, Gwynn Ison, Nancy U Lin, Lia Gore, Thomas S Uldrick, Stuart M Lichtman, Nancy Roach, Julia A Beaver, Rajeshwari Sridhara, Paul J Hesketh, Andrea M Denicoff, Elizabeth Garrett-Mayer, Eric Rubin, Pratik Multani, Tatiana M Prowell, Caroline Schenkel, Marina Kozak, Jeff Allen, Ellen Sigal, Richard L Schilsky
Purpose The primary purposes of eligibility criteria are to protect the safety of trial participants and define the trial population. Excessive or overly restrictive eligibility criteria can slow trial accrual, jeopardize the generalizability of results, and limit understanding of the intervention's benefit-risk profile. Methods ASCO, Friends of Cancer Research, and the US Food and Drug Administration examined specific eligibility criteria (ie, brain metastases, minimum age, HIV infection, and organ dysfunction and prior and concurrent malignancies) to determine whether to modify definitions to extend trials to a broader population...
November 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Nimrod Sachs, Yafit Atiya-Nasagi, Adi Beth-Din, Itzhak Levy, Shalom Ben-Shimol, Diana Tasher, Galia Grisaru-Soen, Haleema Dabaja, Imad Kassis, Shiri Spilman, Efraim Bilavsky
BACKGROUND: Q fever is a zoonosis caused by the bacterium Coxiella burnetii (C. burnetii) with a worldwide distribution. Our aim was to assess the epidemiology, clinical manifestations and treatment regimens of chronic Q fever infections in Israeli children during the past 25 years. METHODS: Cases were collected from the national Q fever reference laboratory database. Demographic, epidemiologic, and clinical data were reviewed using a structured questionnaire sent to the referring physician...
September 20, 2017: Pediatric Infectious Disease Journal
Jocelyn Gravel, Dimitri Ceroni, Laurence Lacroix, Christian Renaud, Guy Grimard, Eleftheria Samara, Abdessalam Cherkaoui, Gesuele Renzi, Jacques Schrenzel, Sergio Manzano
BACKGROUND: Kingella kingae has been increasingly identified in patients with osteoarticular infections. Our main objective was to evaluate the association between carriage of K. kingae in the oropharynx of preschool children and osteoarticular infections. METHODS: We conducted this prospective case-control study in 2 tertiary care pediatric hospitals (Canada and Switzerland) between 2014 and 2016. Potential cases were children aged 6 to 48 months with a presumptive diagnosis of osteoarticular infection according to the treating emergency physician...
September 5, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Nadia Ovchinsky, Warren Frazier, Jeffery J Auletta, Christopher C Dvorak, Monica Ardura, Enkyung Song, Jennifer McArthur, Asumthia Jeyapalan, Robert Tamburro, Kris M Mahadeo, Chani Traube, Christine N Duncan, Rajinder P S Bajwa
Some patients with veno-occlusive disease (VOD) have multiorgan dysfunction, and multiple teams are involved in their daily care in the pediatric intensive care unit. Cardiorespiratory dysfunction is critical in these patients, requiring immediate action. The decision of whether to use a noninvasive or an invasive ventilation strategy may be difficult in the setting of mucositis or other comorbidities in patients with VOD. Similarly, monitoring of organ functions may be very challenging in these patients, who may have fulminant hepatic failure with or without hepatic encephalopathy complicated by delirium and/or infections...
February 2018: Biology of Blood and Marrow Transplantation
Nichole Shaw, Christopher Erickson, Stephanie J Bryant, Virginia L Ferguson, Melissa D Krebs, Nancy Hadley-Miller, Karin A Payne
The physis, or growth plate, is a cartilaginous region at the end of children's long bones that serves as the primary center for longitudinal growth and characterizes the immature skeleton. Musculoskeletal injury, including fracture, infection, malignancy, or iatrogenic damage, has risk of physeal damage. Physeal injuries account for 30% of pediatric fractures and may result in impaired bone growth. Once damaged, cartilage tissue within the physis is often replaced by unwanted bony tissue, forming a "bony bar" that can lead to complications such as complete growth arrest, angular or rotational deformities, and altered joint mechanics...
September 28, 2017: Tissue Engineering. Part B, Reviews
Michael Held, Marie-Fien Bruins, Sophie Castelein, Maritz Laubscher, Robert Dunn, Sven Hoppe
Pediatric tuberculosis (TB) is known to have a wide range of presentations, and if left untreated, primary TB may lead to bone and joint involvement. The literature on this topic is very scarce, and no comprehensive systematic review or meta-analysis of the current knowledge is available to date. The aim of this study is to identify and analyze the literature with highest impact based on citation rate analysis. All databases of the Thomson and Reuters "Web of Knowledge" were used to conduct our search of the 100 most cited articles on this topic published between 1950 and 2014...
July 2017: International Journal of Mycobacteriology
Shima Mahmoudi, Babak Pourakbari, Katayoun Borhani, Mahmoud Khodabandeh, Sepideh Keshavarz Valian, Alireza Aziz-Ahari, Setareh Mamishi
Information concerning the epidemiology of acute osteomyelitis (OM), septic arthritis (SA) and concurrent OM and SA in children is limited. The aim of this study was to describe the epidemiology of OM, SA and concurrent OM and SA in children. During the 4 years of the study, 63,999 patients were admitted to the Children's Hospital, Tehran, Iran. We identified 111 patients with OM and/or SA during the 4‑year period. There were 72 cases of OM (11 cases per 10,000 children) and 90 cases of SA (11 cases per 10,000 children)...
September 2017: Wiener Medizinische Wochenschrift
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