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Osteomyelitis, septic arthritis

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https://www.readbyqxmd.com/read/29081854/toxic-shock-in-children-with-bone-and-joint-infections-a-review-of-seven-years-of-patients-admitted-to-one-intensive-care-unit
#1
D L Kerr, E K Loraas, A C Links, T V Brogan, G A Schmale
PURPOSE: The objective of this study was to compare the frequency of severe systemic, multi-organ involvement and toxic shock syndrome (TSS) in patients with Staphylococcus aureus (SA) and Group A β-haemolytic Streptococcus pyogenes (GABS) bone and joint infections. METHODS: We retrospectively reviewed patients treated for septic arthritis or osteomyelitis at one children's hospital between 2002 and 2009. The rates of intensive care unit (ICU) admission for methicillin-sensitive SA (MSSA), methicillin-resistant SA (MRSA) and GABS infections were compared, as were the lengths of stay, number of surgeries, operative procedures and cases of TSS...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29062623/a-complicated-case-of-group-b-streptococcus-empyema-necessitans
#2
Kevin G Buell, Saira Ajmal, Jennifer A Whitaker
Empyema necessitans is a complication of a pleural space infection that dissects through the pleura into the soft tissues of the chest and skin. Due to the widespread availability of antibiotics, empyema necessitans is rare in modern medicine and is most commonly caused by Mycobacterium tuberculosis. A 38-year-old immunocompetent male presented with left shoulder pain and his chest radiograph revealed a mass in the upper left lung and/or pleural space. He underwent multiple debridements of the chest wall due to a left chest wall abscess and empyema necessitans...
August 22, 2017: Curēus
https://www.readbyqxmd.com/read/29062564/bacille-calmette-gu%C3%A3-rin-vaccine-induced-tuberculous-hip-osteomyelitis-in-an-infant-case-report
#3
Mohammed S Al-Azri, Jazel Manarang, Yaqoub Al-Mufargi
To this day, tuberculosis (TB) continues to pose a significant global health burden. The World Health Organization's Expanded Programme on Immunization (EPI) recommends the bacille Calmette-Guérin (BCG) vaccine for infants to protect against the haematogenous spread of primary TB and other more severe types of TB infection. We report an eight-month-old boy who presented to the Armed Forces Hospital, Muscat, Oman, in 2015 with a one-month history of intermittent fever associated with a limited range of motion in the right hip area...
August 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/28992868/definitive-diagnosis-of-children-presenting-to-a-pediatric-emergency-department-with-fever-and-extremity-pain
#4
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
https://www.readbyqxmd.com/read/28951650/atypical-osteomyelitis-and-concurrent-septic-arthritis-due-to-salmonella-in-immunocompetent-children
#5
Balasubramaniam Balakumar, Sangeet Gangadharan, Nithya Ponmudi, Satish Kumar, John Jude Prakash, Thomas Palocaren
OBJECTIVE: Salmonella osteomyelitis in immunocompromised individuals with sickle cell anaemia is well documented. Its occurrence in immunocompetent children is rare. METHODS: All pus culture positive cases of salmonella typhi between the period 2009 to 2014 were reviewed and only those children without sickle cell disease or trait were considered further. RESULTS: Eighty five patients had positive cultures. Of these only three children had culture positive Salmonella septic arthritis in the absence of sickle cell disease...
July 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28927770/-pyomyositis-in-children-two-cases-of-staphylococcus-aureus-infection
#6
F Gravot, J Hébert, A Robert-Dehault, R Bouttier, F Le Gall, G Blondin, P Vic
Pyomyositis is a term used to denote primary pyogenic infection of a skeletal muscle. It is a rare disease that was first described in immunodeficient patients living in tropical climates. Lately, however, cases involving healthy children have been described in temperate climates. The origin of primary pyomyositis remains unclear, although it is thought to be caused by seeding from transient bacteremia. Onset of disease is insidious, therefore necessitating rapid diagnosis to successfully select appropriate antibiotic therapy and avoid complications...
September 15, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28918656/diagnosing-kingella-kingae-infections-in-infants-and-young-children
#7
Pablo Yagupsky
Kingella kingae is currently recognized as the prime etiology of skeletal system infections in children aged 6-48 months. The organism is notoriously fastidious, its growth is inhibited by synovial fluid and bone exudates, and its presence in clinical specimens is commonly missed by traditional culture methods. Areas covered: The present review discusses the use of improved laboratory methods to detect the organism in normally sterile body fluids, exudates, and upper respiratory tract specimens. Expert commentary: While inoculation of joint and bone exudates into blood culture vials dilutes the concentration of detrimental factors and significantly improves the isolation of the organism, novel PCR-based assays have enhanced sensitivity, shortened the time-to-detection of K...
October 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28917068/group-a-streptococcal-bacteraemia-experience-at-king-fahad-medical-city-in-riyadh-saudi-arabia
#8
Fawzyh J Al-Khadidi, Mohammed A AlSheheri, Tariq S AlFawaz, Mushira A Enani, Abdulaziz A AlAqeel, Dayel A AlShahrani
To identify clinical presentation, predisposing factors, and the outcome in patients with Group A Streptococcal bacteremia. Methods: This is a retrospective study of 33 pediatric and adult patients with Streptococcus pyogenes bacteremia, admitted at King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia from 2007 to 2015. Results: Thirty-three patient records, documenting bacteremia with group A beta-hemolytic streptococcus, were reviewed. Approximately 51.5% were pediatric and 48.5% were adult patients, with a male to female ratio of 2:1...
October 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28900682/treatment-of-staphylococcus-aureus-infections
#9
Michael Z David, Robert S Daum
Staphylococcus aureus, although generally identified as a commensal, is also a common cause of human bacterial infections, including of the skin and other soft tissues, bones, bloodstream, and respiratory tract. The history of S. aureus treatment is marked by the development of resistance to each new class of antistaphylococcal antimicrobial drugs, including the penicillins, sulfonamides, tetracyclines, glycopeptides, and others, complicating therapy. S. aureus isolates identified in the 1960s were sometimes resistant to methicillin, a ß-lactam antimicrobial active initially against a majority S...
September 13, 2017: Current Topics in Microbiology and Immunology
https://www.readbyqxmd.com/read/28874431/association-between-oropharyngeal-carriage-of-kingella-kingae-and-osteoarticular-infection-in-young-children-a-case-control-study
#10
MULTICENTER STUDY
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
https://www.readbyqxmd.com/read/28862129/duration-of-intravenous-antibiotic-therapy-for-children-with-acute-osteomyelitis-or-septic-arthritis-a-feasibility-study
#11
Hans de Graaf, Priya Sukhtankar, Barbara Arch, Nusreen Ahmad, Amanda Lees, Abigail Bennett, Catherine Spowart, Helen Hickey, Annmarie Jeanes, Kate Armon, Andrew Riordan, Jethro Herberg, Scott Hackett, Carrol Gamble, Delane Shingadia, Ann Pallett, Stuart C Clarke, Philip Henman, Marieke Emonts, Mike Sharland, Adam Finn, Andrew J Pollard, Colin Powell, Peter Marsh, Claire Ballinger, Paula R Williamson, Nicholas Mp Clarke, Saul N Faust
BACKGROUND: There is little current consensus regarding the route or duration of antibiotic treatment for acute osteomyelitis (OM) and septic arthritis (SA) in children. OBJECTIVE: To assess the overall feasibility and inform the design of a future randomised controlled trial (RCT) to reduce the duration of intravenous (i.v.) antibiotic use in paediatric OM and SA. DESIGN: (1) A prospective service evaluation (cohort study) to determine the current disease spectrum and UK clinical practice in paediatric OM/SA; (2) a prospective cohort substudy to assess the use of targeted polymerase chain reaction (PCR) in diagnosing paediatric OM/SA; (3) a qualitative study to explore families' views and experiences of OM/SA; and (4) the development of a core outcome set via a systematic review of literature, Delphi clinician survey and stakeholder consensus meeting...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28861207/clinical-outcomes-in-musculoskeletal-involvement-of-burkholderia-pseudomallei-infection
#12
Mohamad Gouse, Viswanath Jayasankar, Shalom Patole, Balaji Veeraraghavan, Manasseh Nithyananth
BACKGROUND: Musculoskeletal involvement in melioidosis is often seen in conjunction with a disseminated illness. Recent reports suggest that operative management of musculoskeletal melioidosis has favourable results. The purpose of this study was to review the patient profile and clinical outcomes of Burkholderia pseudomallei infection in the musculoskeletal system. METHODS: Hospital records of 163 patients who were diagnosed to have B. pseudomallei infection between January 2009 and December 2014 were reviewed...
September 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28853599/pyomyositis-of-the-pectineus-muscle-in-an-adolescent-male
#13
J Hiddema, S Hassan, N Mangat, N Siddiqui
The 'irritable hip' continues to pose a challenge for clinicians. Even with predictive clinical algorithms, decision making can be difficult. Emergency treatment is required if septic arthritis is suspected. Other differential diagnoses such as transient synovitis, pyomyositis of the pelvic girdle muscles and osteomyelitis must be considered in order to help guide appropriate investigations and allow early treatment. We report the case of a 13-year-old boy presenting to our institution with an acutely painful left hip but still able to weight bear...
September 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28760709/antimicrobial-susceptibility-testing-of-kingella-kingae-with-broth-microdilution-and-disk-diffusion-using-eucast-recommended-media
#14
E Matuschek, J Åhman, G Kahlmeter, P Yagupsky
OBJECTIVES: Increasing use of improved culture techniques and sensitive nucleic acid amplification assays have resulted in recognition of Kingella kingae as an important cause of invasive infections in young children, especially in septic arthritis, osteomyelitis, bacteraemia, and endocarditis. In 2016, EUCAST established clinical MIC breakpoints for K. kingae (published in EUCAST Clinical Breakpoint Tables v 7.0, 2017). The present study was carried out to produce MIC-zone diameter correlations for K...
July 29, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28744778/acute-osteomyelitis-and-septic-arthritis-in-children-a%C3%A2-referral-hospital-based-study-in-iran
#15
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)...
July 25, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28723870/osteoarticular-infections-caused-by-streptococcus-pneumoniae-in-children-in-the-post-pneumococcal-conjugate-vaccine-era
#16
Liset Olarte, Jose Romero, William Barson, John Bradley, Philana Ling Lin, Laurence Givner, Tina Tan, Jill Hoffman, Kristina G Hultén, Edward O Mason, Sheldon L Kaplan
BACKGROUND: Pneumococcal osteoarticular infections (OAIs) are an uncommon manifestation of invasive pneumococcal disease (IPD). We describe the demographic characteristics, hospitalization rate, serotype distribution and antibiotic susceptibility of children with pneumococcal OAI over a 16-year period. METHODS: We identified patients ≤18 years old with pneumococcal OAI at 8 children's hospitals in the United States (2000-2015). Pneumococcal isolates were collected prospectively...
December 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28713020/pneumolysin-induced-autophagy-contributes-to-inhibition-of-osteoblast-differentiation-through-downregulation-of-sp1-in-human-osteosarcoma-cells
#17
Jinwook Kim, Hee-Weon Lee, Dong Kwon Rhee, James C Paton, Suhkneung Pyo
BACKGROUND INFORMATION: The 53kDa protein pneumolysin (PLY) is the main virulence factor of Streptococcus pneumoniae, a leading cause of invasive pneumococcal diseases. PLY forms pores in cholesterol-containing membranes, thereby interfering with the function of cells. Bone destruction is a serious matter in chronic inflammatory diseases such as septic arthritis and osteomyelitis. S. pneumoniae is increasingly being recognized as a common cause of septic arthritis, but its pathogenesis is poorly defined...
November 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28706377/nationwide-survey-of-pediatric-septic-arthritis-in-the-united-states
#18
Yusuke Okubo, Kotaro Nochioka, Testa Marcia
BACKGROUND: The epidemiology of pediatric septic arthritis, such as annual hospitalization rates and disparities by age, gender, race/ethnicity, and socioeconomic status, remains unclear. METHODS: We obtained hospital discharge records of patients under the age of 20 years with septic arthritis from the kids inpatient database for 2006, 2009 and 2012. We weighted the records to estimate the number of hospitalizations in the US and calculated the annual rates of hospitalization due to septic arthritis...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28696851/us-evaluation-of-juvenile-idiopathic-arthritis-and-osteoarticular-infection
#19
Jie C Nguyen, Kenneth S Lee, Mahesh M Thapa, Humberto G Rosas
Juvenile idiopathic arthritis (JIA) and osteoarticular infection can cause nonspecific articular and periarticular complaints in children. Although contrast material-enhanced magnetic resonance imaging is the reference standard imaging modality, musculoskeletal ultrasonography (US) is emerging as an important adjunct imaging modality that can provide valuable information relatively quickly without use of radiation or the need for sedation. However, diagnostic accuracy requires a systemic approach, familiarity with various US techniques, and an understanding of maturation-related changes...
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28687092/septic-arthritis-physitis-and-osteomyelitis-in-foals
#20
REVIEW
Kati Glass, Ashlee E Watts
Despite differences in etiology and diagnostics, the mainstay of therapy in the foal is similar to the adult: local lavage and/or debridement and local antimicrobial therapy. When musculoskeletal infection is concurrent with neonatal sepsis, the prognosis for survival is fair. When musculoskeletal infection is the primary problem, the prognosis is fair to good for survival of synovial, bony, and physeal infections with appropriate and aggressive local therapy. Recent literature may indicate that prognosis for survival and potential athleticism in foals that are treated expediently with local therapies and are without comorbidities may be more favorable than has been previously indicated...
August 2017: Veterinary Clinics of North America. Equine Practice
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