Osteomyelitis in a General Pediatric Ward

INTRODUCTION: Pediatric acute osteomyelitis (AO) is a serious condition and a challenging diagnosis. It mainly affects previously healthy individuals and Staphylococcus aureus is the leading causative agent. The objective of this study was to characterize all pediatric AO cases admitted to a second...

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Autores principales:	Mafalda Casinhas Santos, Sara Limão, Ana Sofia Vilardouro, Clara Júlio, Florbela Cunha
Formato:	article
Lenguaje:	EN PT
Publicado:	José de Mello Saúde 2021
Materias:	Child Osteomyelitis/diagnosis Osteomyelitis/therapy Medicine R Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/1fb2c81a43714395b4fface76180590a
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spelling	oai:doaj.org-article:1fb2c81a43714395b4fface76180590a2021-12-04T00:53:03ZOsteomyelitis in a General Pediatric Ward2183-81352184-0628https://doaj.org/article/1fb2c81a43714395b4fface76180590a2021-12-01T00:00:00Zhttps://www.gazetamedica.pt/index.php/gazeta/article/view/497https://doaj.org/toc/2183-8135https://doaj.org/toc/2184-0628 INTRODUCTION: Pediatric acute osteomyelitis (AO) is a serious condition and a challenging diagnosis. It mainly affects previously healthy individuals and Staphylococcus aureus is the leading causative agent. The objective of this study was to characterize all pediatric AO cases admitted to a second-level hospital during a six-year period. METHODS: Retrospective single-center study, including all children under 18 years-old with a primary diagnosis of AO. Descriptive statistics analysis was performed. RESULTS: Ten cases were identified, 60% males. The median age was 6.7 years. Previous trauma was referred by five. Affected locations were foot (n=3), tibia (n=3), femur (n=2), sacrum (n=1) and hand (n=1). All presented with local pain and limping or inability to walk (except one case with hand involvement). Four patients had fever and inflammatory signs, namely erythema and edema, were reported by four. At admission, nine had elevated inflammatory markers and six out of eight had normal radiographs. Magnetic resonance imaging confirmed the diagnosis in seven. Blood cultures were positive for Staphylococcus aureus (n=3) and Streptococcus pyogenes (n=1). Salmonella enteritidis was isolated from pus (n=1) and there was one presumed Kingella kingae AO defined as a positive polymerase chain reaction test from an oropharyngeal swab. The average duration of parenteral and oral antibiotherapy was 14.7 days 3.9 weeks, respectively. The antibiotic of choice was flucloxacillin. Two patients developed local complications. DISCUSSION: An unspecific and subacute clinical and radiological presentation together with low positive blood culture rates difficults timely diagnosis and management. An early empirical parenteral antibiotherapy is mandatory, followed by an oral regimen for at least four weeks. Mafalda Casinhas SantosSara LimãoAna Sofia VilardouroClara JúlioFlorbela CunhaJosé de Mello SaúdearticleChildOsteomyelitis/diagnosisOsteomyelitis/therapyMedicineRMedicine (General)R5-920ENPTGazeta Médica, Vol 1, Iss 1 (2021)
institution	DOAJ
collection	DOAJ
language	EN PT
topic	Child Osteomyelitis/diagnosis Osteomyelitis/therapy Medicine R Medicine (General) R5-920
spellingShingle	Child Osteomyelitis/diagnosis Osteomyelitis/therapy Medicine R Medicine (General) R5-920 Mafalda Casinhas Santos Sara Limão Ana Sofia Vilardouro Clara Júlio Florbela Cunha Osteomyelitis in a General Pediatric Ward
description	INTRODUCTION: Pediatric acute osteomyelitis (AO) is a serious condition and a challenging diagnosis. It mainly affects previously healthy individuals and Staphylococcus aureus is the leading causative agent. The objective of this study was to characterize all pediatric AO cases admitted to a second-level hospital during a six-year period. METHODS: Retrospective single-center study, including all children under 18 years-old with a primary diagnosis of AO. Descriptive statistics analysis was performed. RESULTS: Ten cases were identified, 60% males. The median age was 6.7 years. Previous trauma was referred by five. Affected locations were foot (n=3), tibia (n=3), femur (n=2), sacrum (n=1) and hand (n=1). All presented with local pain and limping or inability to walk (except one case with hand involvement). Four patients had fever and inflammatory signs, namely erythema and edema, were reported by four. At admission, nine had elevated inflammatory markers and six out of eight had normal radiographs. Magnetic resonance imaging confirmed the diagnosis in seven. Blood cultures were positive for Staphylococcus aureus (n=3) and Streptococcus pyogenes (n=1). Salmonella enteritidis was isolated from pus (n=1) and there was one presumed Kingella kingae AO defined as a positive polymerase chain reaction test from an oropharyngeal swab. The average duration of parenteral and oral antibiotherapy was 14.7 days 3.9 weeks, respectively. The antibiotic of choice was flucloxacillin. Two patients developed local complications. DISCUSSION: An unspecific and subacute clinical and radiological presentation together with low positive blood culture rates difficults timely diagnosis and management. An early empirical parenteral antibiotherapy is mandatory, followed by an oral regimen for at least four weeks.
format	article
author	Mafalda Casinhas Santos Sara Limão Ana Sofia Vilardouro Clara Júlio Florbela Cunha
author_facet	Mafalda Casinhas Santos Sara Limão Ana Sofia Vilardouro Clara Júlio Florbela Cunha
author_sort	Mafalda Casinhas Santos
title	Osteomyelitis in a General Pediatric Ward
title_short	Osteomyelitis in a General Pediatric Ward
title_full	Osteomyelitis in a General Pediatric Ward
title_fullStr	Osteomyelitis in a General Pediatric Ward
title_full_unstemmed	Osteomyelitis in a General Pediatric Ward
title_sort	osteomyelitis in a general pediatric ward
publisher	José de Mello Saúde
publishDate	2021
url	https://doaj.org/article/1fb2c81a43714395b4fface76180590a
work_keys_str_mv	AT mafaldacasinhassantos osteomyelitisinageneralpediatricward AT saralimao osteomyelitisinageneralpediatricward AT anasofiavilardouro osteomyelitisinageneralpediatricward AT clarajulio osteomyelitisinageneralpediatricward AT florbelacunha osteomyelitisinageneralpediatricward
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Osteomyelitis in a General Pediatric Ward

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